VA checklist helps bring down suicides among veteran patients

VA checklist helps bring down suicides among veteran patients

A checklist being followed by the Veterans Health Administration (VHA) has helped in reducing suicides at the Veterans Affairs (VA) inpatient mental health units, a recent study has found. The Mental Health Environment of Care Checklist (MHEOCC) has 114 items and it includes questions like are closets free of clothes rods and whether the area is free of unnecessary cords.

The checklist was introduced in 2007 to recognize and decrease environmental hazards that increase the chance of inpatient suicide. It helps in identifying environmental factors that contribute to suicide attempts and other self-injurious behavior among patients. The MHEOCC focuses on the environmental factors that contribute to patient and staff safety.

According to the study, published online in the journal Psychiatric Services in November 2016, the MHEOCC has helped in reducing suicides at the VA inpatient mental health units. Due to the inclusion of the checklist, the inpatient mental health units showed a sharp decline in suicide rate during 2000-2015.

As per the study, the checklist contributed to a sustained reduction in inpatient suicide rates. According to the study’s lead author, Dr. Vince Watts, it appears that the MHEOCC substantially reduced deaths caused due to inpatient suicides and that environmental and architectural changes may lead to a reduction in suicides in hospital units.

Most suicides in inpatient units were linked to environmental hazards

As per a previous analysis, most of the attempted and completed suicides in inpatient units were linked to environmental hazards, such as a hook that could be used for hanging. In 2006, when the VA set out to identify suicide hazards in psychiatric units, they found that the checklist diminished 73 percent of the hazards identified in the first year.

Among the top hazard-ridden locations in psychiatric units, bathrooms topped the chart, followed by bedrooms and corridors. As per the VA study, the anchor points accounted for 44 percent of identified hazards. It also identified ceilings as a considerable hanging hazard.

According to Peter Mills, Ph.D., director of the VA National Center for Patient Safety Field Office, often the usual harmless objects become environmental hazards and should be considered in efforts to combat suicides among patients receiving care in an inpatient setting.

As per Dr. Mills, each year about 1,500 inpatient suicides occur in the U.S. hospitals. According to Dr. Mills, in terms of suicide rate in Veterans Administration Medical Centers (VAMC), between December 1999 and December 2011, there were 471 attempted suicides in the VHA facilities. Among the 65 completed suicides, about 45 percent took place in the inpatient psychiatric units.

In a 2010 study, Dr. Mills and his colleagues found that during the first year of its execution, the checklist helped 113 mental health units in VA facilities identify and rate 7,642 hazards. The identification helped the VA facilities address 5,834 of such hazards in the psychiatric units by the end of the first year. As per a study published in the Joint Commission Journal on Quality and Patient Safety in February 2010, suicide hazards often go unrecognized until something goes wrong.

Other effective approaches can also help

The recent study is an extension of a 2012 report led by Dr. Watts that linked the MHEOCC to a drop in inpatient suicide rate at VHA mental health units. The study also revealed that in addition to structural changes, there may be other effective approaches to help provide effective care for patients with mental illnesses.

Some of the other strategies for preventing inpatient suicides included conducting frequent checks on patients, training staff in a better manner and encouraging a culture that rewarded incident-reporting.

Treatment for mental illness is available

Mental illnesses, when left untreated, can give rise to suicidal tendencies. However, if recognized on time and addressed accordingly, suicide can be prevented.

If you know someone who is suffering from a mental disorder and has suicidal tendencies, contact Sovereign Health to access one of our mental health centers in California or any other state. Call at our 24/7 helpline number 866-973-7164 or chat online with experts to know about our top depression treatment centers in California.

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