Integrating physical and behavioral health to lower suicide risk

It is often said: healthy mind, healthy body, healthy life. At the 882-bed Parkland Health and Hospital System in Dallas, marrying physical and behavioral health is not just a saying, but a priority across all departments.

A recent webinar from Parkland – which pointed out the grim statistics that the U.S. recorded more than 48,000 suicide-related deaths in 2018, with nearly 500,000 patients treated for self-inflicted injuries – discussed why the health system took the important steps of screening all patients for suicide risk factors. For instance, research has shown that suicide risk is under-identified, individuals who die by suicide are more likely to encounter non-psychiatric providers, and brief screenings can identify those at risk and connect them with needed treatment.

To do this, the health system had to overcome early challenges. Does Parkland have enough resources? Will these screenings cause delays in care? And, how will they track screenings and outcomes?

As the system worked through these questions, providers realized they were identifying more at-risk individuals who were engaged with their health care system for unrelated injuries and illnesses; these patients otherwise might not have connected with needed mental health services.

We recently sat down with several leaders of this work at Parkland Health and Hospital System to discuss how they brought this program to the ambulatory, inpatient and ED space and the value these screenings have brought both to their patients and the teams caring for them. On the first, David Herrman, motivational interviewing trainer of suicide risk assessment and intervention, talks about “motivational interviewing” – a client-centered counseling style for eliciting behavior change – and how it has been used at Parkland to assess patients for suicide risk. Then listen to Minnie Matthews, director of global behavioral health, and Pedro Fernandez, co-chief of psychiatry and assistant professor of psychiatry at UT Southwestern Medical Center, discuss sustainable and practical approaches to marrying physical and behavioral health care. Also, hear behavioral health social work managers Jenny Esparza and Diann Francis’ thoughts on reducing suicide across the inpatient, emergency department and outpatient settings. Listen to all three podcasts here.

As COVID-19, civil unrest and economic and political factors contribute to greater isolation and potential for increased deaths of despair, linking healthy bodies and healthy minds is a practice we all must follow.
 

Elisa Arespacochaga is vice president of the AHA Physician Alliance; and Rebecca Chickey is the AHA’s senior director of Behavioral Health Services, field engagement.