The National Center for Health and Justice Integration for Suicide Prevention

与正义有关的个人有很高的自杀特征、状态和诱发风险因素，这是 美国每年有相当大比例的自杀者，而且许多人与护理没有很好的联系。国家中心 卫生与司法一体化预防自杀(NCHATS)：(1)使用与司法系统的联系 (2)作为一般人群自杀风险的新指标； 高效跟踪司法参与的大数据系统可以链接到医疗系统记录，并扩展到 确定有自杀风险的人，并将他们与护理联系起来；以及(3)检查有效性和可扩展性 使用这些方法预防自杀的方法。中心项目是混合有效性-实施 检查自杀预防活动的有效性、成本效益和可伸缩性的研究 通过将司法和卫生数据联系起来。鉴于与司法系统的接触是自杀风险的迹象， 跨司法/卫生系统的大数据集成，以标记系统之间的移动(因此是自杀 风险)提供了一种在一般人群中识别自杀风险的新方法。此方法不需要 从这些难以接触到的人群中收集新的数据。相反，它建立了有效链接现有数据的策略 并测试应对方法。这是一种创新且具有潜在可扩展性的识别/解决方案 与标准医疗保健没有很好联系的个人的自杀风险。该中心的创新之处在于：(1) 建立针对大量高危目标人群的自杀预防干预效果基地， (A)在司法人员中开展仅有的3个全能预防自杀研究中的2个，以及(B)最大的防止自杀研究 到目前为止，对涉及司法公正的人口中的任何情况进行任何干预；(2)制定和手册 可伸缩性和可持续战略--实施科学研究不足的领域；(3)与 司法系统作为一般人群自杀风险的新指标；(4)使用社会计量识别 促进中心方法的传播和传播的关键个人；(5)展示了如何有效地、 实现了可概括的健康和司法系统大数据链接，并可用于自动化自杀风险 在卫生和司法系统中进行大规模的识别和应对。这在实践中是极其罕见的。 而且以前从未作为改善正义人群健康结果的方法进行过测试。通过将 虽然我们知道该中心的案例很少，但我们已做好准备迅速推进这一领域。中心目标是 ：(1)评估利用司法联系预防自杀方法的效力和成本效益 作为风险和卫生/司法系统数据链接的标志，以提供可扩展的方式提醒提供者注意这一风险； (2)最大限度地提高已确定方法的可扩展性、可持续性、相关性和传播，并确定、改进、 并将可伸缩性/维持战略付诸实施，以便在今后的试验中得到充分检验；以及(3)促进国家 在司法拦截处预防自杀方面的研究和实践能力。合作伙伴包括监狱、警察、卫生 计划、医疗保健系统、法院、法官、社区矫正、种族平等和生活体验。

Justice-involved individuals have high rates of trait, state, and precipitating risk factors for suicide, account for a significant proportion of U.S. suicides each year, and many are not well-connected to care. The National Center for Health and Justice Integration for Suicide Prevention (NCHATS): (1) uses contact with the justice system (e.g., police contact, arrest) as a novel indicator of suicide risk in the general population; (2) demonstrates how big data systems that efficiently track justice involvement can be linked to health system records and scaled to identify individuals at risk for suicide and connect them to care; and (3) examines effectiveness and scalability of suicide prevention approaches using these methods. Center projects are hybrid effectiveness-implementation studies that examine effectiveness, cost-effectiveness, and scalability of suicide prevention activities triggered through linkage of justice and health data. Given that contact with the justice system is a sign of risk for suicide, big data integration across justice/health systems to flag movement between systems (and therefore suicide risk) provides a novel method of identifying suicide risk in the general population. This approach does not require collecting new data from this hard-to-reach population. Rather, it sets up strategies to efficiently link existing data and to test methods to respond. This is an innovative and potentially scalable approach to identify/address suicide risk for individuals not well-connected with standard health care. The Center is innovative in that it: (1) establishes a suicide prevention intervention effectiveness base for a large and high-risk target population, conducting (a) 2 of only 3 fully-powered suicide prevention RCTs in justice populations, and (b) the largest RCTs of any intervention for any condition in a justice-involved population to date; (2) develops and manualizes strategies for scalability and sustainment -- understudied areas of implementation science; (3) uses contact with the justice system as a novel indicator of suicide risk in the general population; (4) uses sociometric identification of key individuals to promote diffusion and dissemination of Center approaches; (5) demonstrates how efficient, generalizable health and justice system big data linkage is achieved and can be used to automate suicide risk identification and response across health and justice systems at scale. This is extremely rarely done in practice and never before tested as a method of improving health outcomes in justice populations. By incorporating the few cases of which we are aware into this Center, we are poised to rapidly advance the field. Center aims are to: (1) Evaluate effectiveness and cost-effectiveness of suicide prevention approaches that use justice contacts as markers of risk and health/justice system data linkage to provide scalable ways to alert providers of this risk; (2) Maximize scalability, sustainability, relevance, and dissemination of identified approaches and identify, refine, and manualize scalability/sustainment strategies to be fully tested in future trials; and (3) Promote national research and practice capacity in suicide prevention at justice intercepts. Partners include jails, police, health plans, healthcare systems, courts, judges, community corrections, racial equity, and lived experience.