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8 Developing Networks and Sharing Information
Pages 75-84

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From page 75...
... BUILDING A LEARNING HEALTH CARE SYSTEM FOR SUICIDE PREVENTION The Mental Health Research Network, Simon explained, comprises 13 large, integrated health care systems and their affiliated or embedded research centers which together serve some 14 million Americans. Aside from providing comprehensive care, these integrated health systems also provide insurance coverage, and all have longitudinal electronic health record (EHR)
From page 76...
... First, the health system partners rapidly implemented a standard-of-care process because they did not want to wait for further evidence before acting. The process consisted of providers administering the Columbia Suicide Severity Rating Scale instru­ ent and, if the score indicated a significant risk, the care team cre m ating a safety plan addressing lethal means, including a routine assessment of access to firearms, and recording that in the EHR.
From page 77...
... The team linked those models to data from ­ ecords about nonfatal suicide attempts within 90 days and state mortalr ity records about subsequent suicide deaths. From past mental health and medical diagnoses and service use patterns this analysis defined approximately 150 potential clinical predictors and 200 possible interactions among them.
From page 78...
... The models will also be used to do outreach between visits to people who either cancel a visit or fail to show up for a visit using the ability to recalculate risk scores daily on every member in its service population. Simon noted that the technical tools to develop and validate the models are in a public GitHub repository.1 Going forward, Simon said, the network is planning a large trial to determine if one of the new glutamate receptor modulator ketamine-like drugs, which have been shown to rapidly decrease suicide ideation, actually reduce the risk of suicide attempts and suicide deaths as well.
From page 79...
... "As long as we are working in silos," she said, "we are going to continue to see problems the same way that we have always seen them and see solutions the same way, and if we want to get innovative, if we want to do new things, we are going to have to make friends." Hospital-based violence intervention programs (HVIPs) , which by ­ design require collaboration among different members of a health care team, are at their core efforts to promote positive alternatives to violence.
From page 80...
... Other places from which to identify potential collaborators include national organizations such as the Brady Campaign and a variety of local community and state organizations. Ashley encouraged people to look for some level of overlap in a potential collaborator who on the surface may not appear to share the goal of addressing firearm violence.
From page 81...
... For example, she said, the best practices that have been discussed at the national conference of the Healing Justice Alliance include treating violence as a public health issue, the value of HVIPs, the need to involve prevention professionals, the importance of listening to communities, and the role that trauma-informed care and mental health services can play in preventing gun violence. Other best practices that Ashley listed include not dismissing practice-based evidence generated by groups working in the community that may not hit the gold standard of research, particularly regarding culturally specific practices; implementing both screening and interventions, because just screening for the problem is not helpful; and making research applicable to the community.
From page 82...
... Simon replied that predicting suicide death, which is a relatively rare event, would require large datasets to make good predictions. Predicting suicide attempts would require a smaller dataset, and predicting suicidal ideation an even smaller dataset.
From page 83...
... One non-member effort in San Diego, for example, was using clergy as its initial contact point with individuals, but there is not a formal arrange­ ent between the national network and any particular faith-based m organization. In response to a question about the use of "prevention professionals," Kyle Fischer explained that the idea behind creating that title was to provide a means for health systems to recognize an intervention specialist who comes from the community and who does not fit into any existing category in the current medical model.
From page 84...
... The coordinating center's annual budget is a few hundred thousand dollars, and each participating site receives a sustaining budget of approximately $60,000 per year. Research projects receive separate funding through individual research grants that network members submit.


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