Established outpatient care and follow-up after acute psychiatric service use among youths and young adults

Objective: This study explored follow-up after hospitalization and emergency room (ER) use for mental health among youths and young adults with private insurance. Methods: The IBM MarketScan commercial database (2013–2018) was used to identify people ages 12–27 with a mental health hospitalization (N=95,153) or ER use (N=108,576). Factors associated with outpatient mental health follow-up within […]

Hopelessness, interpersonal, and emotion dysregulation perspectives on suicidal ideation: Tests in a clinical sample

Objective The present study directly compared three perspectives of suicidality: Interpersonal Theory of Suicide (IPTS), Hopelessness Theory, and a perspective emphasizing emotion dysregulation. Method 219 adults seeking outpatient psychological services completed questionnaires during intake between November 2015 and February 2019. Patients were included if they completed surveys related to thwarted belongingness (TB), perceived burdensomeness (PB), […]

Persistent suicidal ideation in a large intensive outpatient adolescent population sample: A preliminary report on the role of sleep disturbance

Sleep disturbance is a unique, yet understudied, risk factor for suicidal thoughts and behaviors (STBs). The present study sought to explore the relationship between suicidal ideation (SI) and self-reported sleep disturbance in a sample of adolescents in an intensive outpatient program targeting suicidality (N = 691). Analyses conducted include paired samples t tests, multiple linear […]

Family involvement in psychiatric hospitalizations: Associations with discharge planning and prompt follow-up care

Objective: Involving family in the care of inpatients with serious mental illness is known to be beneficial. This study examined frequencies of involvement by family in the care and discharge planning for 179 psychiatric inpatients. Methods: Involvement by family in care and discharge planning was assessed from randomly selected medical records of inpatients with Medicaid and severe […]

Five-year mortality after hospitalisation for suicide attempt with a violent method

Objective This study aimed to estimate the 5-year mortality among people admitted into a transdisciplinary unit providing combined psychiatric and somatic rehabilitation treatment. Methods In this retrospective study, we analyzed the clinical records of all individuals admitted into the transdisciplinary unit from 01/01/2011 to 12/31/2017 after a suicide attempt using violent means. Vital status was […]

Spreading a strategy to prevent suicide after psychiatric hospitalization: Results of a quality improvement spread initiative

Background Suicide after psychiatric hospitalization is a major concern. Poor treatment engagement may contribute to risk. The World Health Organization Brief Intervention and Contact (BIC) Program is an evidence-based practice shown to prevent suicide after psychiatric discharge in international trials. There have been no efforts to implement BIC into routine practice in US populations. Methods […]

Meta-analysis of suicide rates in the first week and the first month after psychiatric hospitalisation

Objective To assess the magnitude of suicide rates in the first week and first month postdischarge following psychiatric hospitalisation. Design Meta-analysis of relevant English-language, peer-reviewed papers published in MEDLINE, PsycINFO or Embase between 01 January 1945 and 31 March 2017 and supplemented by hand searching and personal communication. A generalised linear effects model was fitted […]

A pilot randomized trial of a brief intervention to prevent suicide after inpatient psychiatric discharge

Objective: Risk for suicide is high after psychiatric hospitalization. The World Health Organization’s Brief Intervention and Contact (BIC) program has shown efficacy in preventing suicide. A version adapted for the U.S. Department of Veterans Affairs (VA) was studied to determine preliminary effects. Methods: Patients receiving psychiatric hospitalization because of acute risk for self-harm were randomly […]

Best practices in care transitions for individuals with suicide risk: Inpatient care to outpatient care

This report presents feasible, evidence-based practices that health systems can take to improve patient engagement and safety during the transition from inpatient to outpatient care.

Cost-effectiveness of a contact intervention and a psychotherapeutic program for post-discharge suicide prevention

Objective: To determine the cost-effectiveness of 2 strategies for post-discharge suicide prevention, an Enhanced Contact intervention based on repeated in-person and telephone contacts, and an individual 2-month long problem-solving Psychotherapy program, in comparison to facilitated access to outpatient care following a suicide attempt. Methods: We conducted a cost-effectiveness analysis based on a decision tree between January and […]

Discharge of the emergency patient with risk factors for suicide: Psychiatric and legal perspectives. In: Zun L.S., Nordstrom K., Wilson M.P. (eds) Behavioral Emergencies for Healthcare Providers

Over the last 30 years, the psychiatric approach to individuals in the emergency setting with suicidal ideation and risk factors for suicide has undergone a paradigm shift, from one favoring triage and hospitalization to one favoring treatment and hospital diversion. In the best hands, the goal has always been to collaborate with the patient in […]

Risk of suicide after discharge from inpatient psychiatric care: A systematic review

The period following discharge from inpatient psychiatric care is recognised as an especially high-risk time for patient suicide. Astonishingly, there is a dearth of comprehensive studies examining risk and protective factors in this specific population. The aim of this study was to establish the protective and risk factors for suicide in the first year post-discharge […]

Individuals at risk for suicide: Mental health clinicians’ perspectives on barriers to and facilitators of treatment engagement

Background: Individuals experiencing suicidal ideation and/or behaviors are often difficult to engage in treatment. Up to 50% of individuals presenting to an ER for treatment of a suicidal crisis refuse outpatient treatment referrals. This study examined outpatient mental health clinicians’ perceptions of the barriers to and facilitators of mental health treatment engagement of individuals at […]

Patient outcomes following discharge from secure psychiatric hospitals: Systematic review and meta-analysis.

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Psychiatric comorbidity, suicidality, and in-home firearm access among a nationally representative sample of adolescents.

Suicide is the second leading cause of death among US adolescents, and in-home firearm access is an independent risk factor for suicide. Given recommendations to limit firearm access by those with mental health risk factors for suicide, we hypothesized that adolescents with such risk factors would be less likely to report in-home firearm access. Adolescents […]

Clinical correlates of non-suicidal self-injury (NSSI) in an outpatient sample of adolescents.

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Safety of patients under the care of crisis resolution home treatment services in England: A retrospective analysis of suicide trends from 2003-2011.

Community care provided by crisis resolution home treatment teams is used increasingly as an alternative to admission to psychiatric wards. No systematic analysis has been done of the safety of these teams in terms of rates of suicide. We aimed to compare the rate and number of suicides among patients under the care of crisis […]

Clinical and sociodemographic characteristics associated with suicidal ideation in depressed outpatients.

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Effects of an emergency department mental health intervention for linking pediatric suicidal patients to follow-up mental health treatment: A randomized controlled trial.

Suicide is the third leading cause of death among adolescents. Many suicidal youths treated in Emergency Departments (EDs) do not receive follow-up treatment, as advocated by our National Strategy for Suicide Prevention. We compared two strategies for improving rates of follow-up treatment. Methods Randomized controlled trial in which suicidal youths at two EDs (N=181; aged […]

Outpatient mental health treatment initiation and response in at-risk youth after suicide screenings.

Suicide screening programs have dramatically expanded over the past two decades, partially due to government support of screening initiatives. However, little is known about the outcome of suicide screening programs, particularly in relation to youth mental health treatment utilization and treatment response over time, as only a handful of studies of screening programs have included […]