The National Center for Health and Justice Integration for Suicide Prevention

涉及司法的个人有很高的自杀的特质，状态和突发风险因素，解释了一个 美国每年自杀的比例很大，许多人与护理没有很好的联系。国家中心 健康和司法一体化预防自杀（NCHATS）：（1）使用与司法系统的联系 (e.g.,警察接触，逮捕）作为一般人群自杀风险的新指标;（2）演示如何 有效跟踪司法参与的大数据系统可以与卫生系统记录相关联，并扩展到 识别有自杀风险的个人，并将他们与护理联系起来;（3）检查有效性和可扩展性 使用这些方法的自杀预防方法。中心项目是混合型的有效性-实施 调查自杀预防活动的有效性、成本效益和可扩展性的研究 通过司法和健康数据的联系。鉴于与司法系统接触是自杀风险的标志， 跨司法/卫生系统的大数据集成，以标记系统之间的移动（从而标记自杀 风险）提供了一种识别一般人群自杀风险的新方法。这种方法不需要 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。这是一种创新的、具有潜在可扩展性的方法， 与标准医疗保健没有良好联系的个人的自杀风险。该中心的创新之处在于：（1） 为庞大的高危目标人群建立自杀预防干预有效性基础， 在司法人群中进行（a）3项完全有效的自杀预防RCT中的2项，以及（B）最大的RCT （2）开发和手动化 可扩展性和可持续性的战略--实施科学的未充分研究的领域;（3）使用与 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 （5）展示如何有效地， 实现了可推广的卫生和司法系统大数据链接，并可用于自动化自杀风险 在整个卫生和司法系统大规模地进行识别和应对。这在实践中是极其罕见的 而且以前从未被测试过作为改善司法人口健康结果的方法。通过并入 我们所知道的几个案例进入这个中心，我们准备迅速推进这一领域。中心的目标是 目的：（1）评估使用司法联系人的自杀预防方法的有效性和成本效益 作为风险标志和卫生/司法系统的数据链接，以提供可扩展的方式提醒服务提供者注意这一风险; (2)最大限度地扩大所确定的方法的可扩展性、可持续性、相关性和传播， 并将可扩展性/可持续性战略手册化，以便在今后的试验中进行充分测试;以及（3）促进国家 在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，种族平等和生活经验。

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.