Zero Suicide Implementation and Evaluation in Outpatient Mental Health Clinics
Zero Suicide Implementation and Evaluation in Outpatient Mental Health Clinics
批准号:
9237597
负责人:
BARBARA STANLEY
金额:
$79.46万
依托单位国家:
美国
项目类别:
财政年份:
2016
资助国家:
美国
项目状态:
已结题
起止时间:
2016-09-15 至 2021-06-30
关键词:
Accident and Emergency departmentAdoptedAdoptionAffectAmbulatory CareAmbulatory Care FacilitiesApplied ResearchAssessment toolCaringCessation of lifeClientClimateClinicConsultationsContinuity of Patient CareCountryDataData CollectionDetectionDevelopmentEducational InterventionEffectivenessElementsEmergency department visitEnabling FactorsEvaluationEventEvidence based practiceEvidence based treatmentGeneral PopulationHappinessHealthcareHealthcare SystemsHospitalizationHybridsImpact evaluationIndividualInterventionLeadershipLearningLicensingLifeLocationMaintenanceMeasuresMediator of activation proteinMental HealthMethodsModelingNew YorkOutcomeOutpatientsPathway interactionsPennsylvaniaPhasePositioning AttributePredisposing FactorProcessProtocols documentationProviderRandomizedReinforcing FactorReportingResearch InfrastructureRisk AssessmentSafetySeveritiesSiteStratificationSuicideSuicide attemptSuicide preventionSystemTestingTimeTrainingTreatment outcomeUniversitiesVisitWorkadministrative databasebasebehavioral healthcare systemscohortcompare effectivenessdesignethnic diversityexperiencefallsfollow-uphigh riskimprovedinsightreducing suicideresponsescreeningsuccesssuicidalsuicidal behaviorsuicidal individualsuicidal morbiditysuicidal risksuicide modelsuicide ratetreatment as usualuptake
中文摘要
项目总结
英文摘要
PROJECT SUMMARY
Despite development of evidenced-based treatments and assessment tools, the number of suicide
deaths in the US has risen dramatically in the past decade. The suicide rate of outpatients in behavioral health
care is 100x higher than the general population, and >25% who die by suicide and >50% of those who attempt
receive care in outpatient behavioral health settings in the prior year. Unfortunately, evidenced-based practices
have not found their way into routine outpatient care. As such, outpatient clinics are a critical location for
suicide prevention efforts, and improving suicide prevention practices holds promise for reducing suicide. The
ZS model is a multi-component (including assessment, intervention, and continuity of care), system-wide
approach based on the assumption that suicide within the health care system is preventable. Given that the ZS
approach is being promoted nationally, it is important to ascertain what factors affect its effectiveness and what
intensity of implementation achieves maximal uptake. In this project, we propose to conduct a large scale
implementation and evaluation of the ZS model in outpatient behavioral health. We will implement ZS
strategies in 145 clinics in New York State (NYS) serving >80,000 behavioral health clients. This project
combines efforts with the NYS Office of Mental Health’s Continuous Quality Improvement unit, and benefits
from the State's well-developed, existing administrative database infrastructure, including mandated reporting
of suicide attempts and deaths for individuals in care and client-, clinic-, and agency-level data on treatment
attendance, hospitalizations, and Emergency Department visits.
Using a hybrid effectiveness-implementation type 1 design, we will test the effectiveness of ZS in 145
outpatient state licensed (but not state operated) clinics. We will randomly-assign agencies to one of two
conditions: “Basic Implementation” (BI) or “Enhanced Implementation” (EI; enhanced training/consultation, use
of site champions, participatory learning collaboratives). In Aim 1, we will compare the effectiveness of EI and
BI conditions in reducing suicidal behaviors (attempts and deaths), psychiatric hospitalizations, and ED visits.
We will conduct cohort and historical comparison analyses to determine the effectiveness of ZS conditions vs
“treatment-as-usual." In Aim 2, we will use mixed qualitative-quantitative approaches to compare the EI and BI
conditions on implementation and sustainability of the ZS model. We will use the Precede-Proceed framework
to evaluate agency- and provider-level predisposing, enabling, and reinforcing factors affecting implementation
success, as well as rates and quality of ZS components (process/impact evaluation) during implementation,
maintenance, and follow-up periods. This study will be the largest implementation and evaluation of the ZS
approach ever conducted, and will provide crucial insight regarding broader dissemination. Results will inform
how to best adopt empirically-supported, suicide-safe care, thereby reducing tragic and preventable loss of life.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
Suicidal Behavior: Aggression Subtypes, Childhood Adversity and Stress Response
-
批准号:8917366
-
项目类别:
-
资助金额:$0.0万
-
财政年份:2014
-
负责人:BARBARA STANLEY
-
依托单位:
Suicidal Behavior: Aggression Subtypes, Childhood Adversity and Stress Response
-
批准号:8605257
-
项目类别:
-
资助金额:$14.38万
-
财政年份:2013
-
负责人:BARBARA STANLEY
-
依托单位:
Stress, Inflammation, Aggression and Emotion Regulation in Suicidal Behavior
-
批准号:10207367
-
项目类别:
-
资助金额:$15.95万
-
财政年份:2013
-
负责人:BARBARA STANLEY
-
依托单位:
Stress, Inflammation, Aggression and Emotion Regulation in Suicidal Behavior
-
批准号:10408797
-
项目类别:
-
资助金额:$15.36万
-
财政年份:2013
-
负责人:BARBARA STANLEY
-
依托单位:
Treating Suicidal Behavior and Self-Mutilation in BPD
-
批准号:8036654
-
项目类别:
-
资助金额:$25.76万
-
财政年份:2010
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:7904453
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项目类别:
-
资助金额:$15.97万
-
财政年份:2009
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:6831522
-
项目类别:
-
资助金额:$66.62万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:7479190
-
项目类别:
-
资助金额:$76.5万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:7119247
-
项目类别:
-
资助金额:$64.51万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:7280779
-
项目类别:
-
资助金额:$62.78万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:7479453
-
项目类别:
-
资助金额:$14.03万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
DCIPS: Intervention with High Suicide Risk Individuals
-
批准号:6952010
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项目类别:
-
资助金额:$65.92万
-
财政年份:2004
-
负责人:BARBARA STANLEY
-
依托单位:
Prospective Study of Suicidal Behavior in BPD
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批准号:6700293
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项目类别:
-
资助金额:$30.31万
-
财政年份:2002
-
负责人:BARBARA STANLEY
-
依托单位:
Prospective Study of Suicidal Behavior in BPD
-
批准号:6438066
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项目类别:
-
资助金额:$30.31万
-
财政年份:2002
-
负责人:BARBARA STANLEY
-
依托单位:
Prospective Study of Suicidal Behavior in BPD
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批准号:6621987
-
项目类别:
-
资助金额:$30.31万
-
财政年份:2002
-
负责人:BARBARA STANLEY
-
依托单位:
Prospective Study of Suicidal Behavior in BPD
-
批准号:6844903
-
项目类别:
-
资助金额:$30.31万
-
财政年份:2002
-
负责人:BARBARA STANLEY
-
依托单位:
Prospective Study of Suicidal Behavior in BPD
-
批准号:7010026
-
项目类别:
-
资助金额:$29.59万
-
财政年份:2002
-
负责人:BARBARA STANLEY
-
依托单位:
TREATING SUICIDAL BEHAVIOR AND SELF MUTILATION IN BPD
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批准号:6392718
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项目类别:
-
资助金额:$90.16万
-
财政年份:2000
-
负责人:BARBARA STANLEY
-
依托单位:
TREATING SUICIDAL BEHAVIOR AND SELF MUTILATION IN BPD
-
批准号:6539046
-
项目类别:
-
资助金额:$92.85万
-
财政年份:2000
-
负责人:BARBARA STANLEY
-
依托单位:
Treating Suicidal Behavior and Self-Mutilation in BPD
-
批准号:8069865
-
项目类别:
-
资助金额:$63.28万
-
财政年份:2000
-
负责人:BARBARA STANLEY
-
依托单位:
海外基金