Puerto Rico Suicide Prevention: How Hospital Emergency Screenings Can Help
Our Island was hit hard by different natural disasters since 2017 with Hurricane Maria, and 2020 has been particularly harder with earthquakes followed by the COVID-19 pandemic.
Last year, Puerto Rico had over 900,000 calls to the PAS line related to the suicide line[1]. This lets us know the level of stress we have on the Island.
An article published in The Wall Street Journal by Andrea Petersen says that "More than one-third of Americans say the pandemic is having a “serious impact” on their mental health" [2]. That is a significant number of persons.
Depression Screening and Suicide Prevention are important now more than ever, with so many people struggling to recover from these events. Hospital Emergency Screens are a great way to start.
Patients can bring different illnesses to hospitals, but the mental issues might be undisclosed at simple eyesight. That is why hospitals can prevent suicides, with a screening process, that can catch someone who may need professional counseling or even emergency treatment for depression so it doesn't progress into suicide.
Meditech’s Depression Screening and Suicide Prevention toolkit offers advanced clinical decision support that helps healthcare staff diagnose depression and suicidal ideation in real-time surveillance, documentation tools, and registry patient monitoring.
By implementing these screening methods into the hospital's EHR, the hospital will be able to better manage patients' conditions while preventing future suicidal behavior through early detection and intervention.
Some additional components of this toolkit include:
On-demand video education
Outcomes-centered workflow guide
Setup guidance
Decision log
Change log
Reference/supporting information
FAQs
The hospital emergency room is the most accessible health-based center to offer suicide prevention screenings. These screenings should be part of a progressive framework known as “Zero Suicide” [3] that offers seven elements of safe and effective suicide care:
Lead system-wide culture change committed to reducing suicides.
Train a competent, confident, and caring workforce.
Identify individuals with suicide risk via comprehensive screening and assessment.
Engage all individuals at-risk of suicide using a suicide care management plan.
Treat suicidal thoughts and behaviors directly using evidence-based treatments.
Transition individuals through care with warm hand-offs and supportive contacts.
Improve policies and procedures through continuous quality improvement.
Zero Suicide Framework from Zero Suicide Website: https://zerosuicide.edc.org/
A successful hospital screening process is crucial because it can lead to early identification of people at risk; targeted interventions during the critical window before they act on suicidal thoughts; which results in fewer suicides.
The hospital staff member conducting the evaluation must complete sections on symptoms during the interview using semi-structured questioning techniques. They document everything they learn in the patient’s electronic health record (EHR).
In order to be more effective, screenings should happen as soon as possible, so there are fewer delays between assessment and treatment when someone needs help. Waiting too long could result in a patient committing suicide.
- Depression is a serious medical illness that affects over 15 million Americans each year, and nearly half the adult population knows someone who has had depressive symptoms in their lifetime.
- Depression can be treated with psychotherapy (including cognitive behavioral therapy), antidepressants, or both; however, depression remains undertreated in the United States and Puerto Rico.
- Hospital emergency screenings provide an opportunity for professionals to identify patients who may need help quickly, so they don't get worse or commit suicide before getting the treatment.
Depression is vital to be identified - in research, it was found that people who screened positive for depression were more likely to commit suicide than those with negative screenings (Reeves et al., 2012).
Apart from empowering the healthcare staff for early screening, the most important thing we can do is educate ourselves about mental health. Understanding the depression symptoms and the risk factors associated with suicides will make us better prepared to know how to seek help before committing an act of self-harm or, worse, death.
Trinexus can help in the EHR implementation and Meditech’s Depression Screening and Suicide Prevention toolkit, but to learn more about mental health or to receive help, please call the PAS line at 1-800-981-0023, or you can also download their mobile app at:
Apple - https://apps.apple.com/us/app/l%C3%ADnea-pas-assmca/id1495909225
Google Play - https://play.google.com/store/apps/details?id=gov.pr.assmca.lineapas
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[1] Informe mensual de Suicidios en Puerto Rico - Enero 2021, Comisión para la Prevención del Suicidio, Departamento de Salud de Puerto Rico, - http://www.salud.pr.gov/Estadisticas-Registros-y-Publicaciones/Estadisticas%20Suicidio/2021/Enero%202021.pdf
[2] The Struggle to Cope With Depression Amid Coronavirus by Andrea Petersen April 12, 2020 9:00 am ET - https://adaa.org/sites/default/files/WSJ%20Article%20-%20Depression%20-%20Charles%20Nemeroff%20April%2012%202020.pdf
[3] Zero Suicide Framework from Zero Suicide Website: https://zerosuicide.edc.org/