21 Jan Mental Health Services Linked To Lower Suicide Rate in Large HMO
MedicalResearch.com Interview with:
M. Justin Coffey MD
Menninger Department of Psychiatry & Behavioral Sciences
Baylor College of Medicine
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Coffey: Although both the US Surgeon General and the Institute of Medicine have called on health care systems to reduce suicide, the few assessments of suicide in such systems have examined only specific patient groups and not the entire population of health plan members. Our study reports the first information on suicide for the entire membership of a large health maintenance organization (HMO). The findings provide a previously unavailable baseline data for health care systems who are engaged in important efforts to measure and prevent suicide.
We identified all suicides among the entire membership of our HMO network between 1999 and 2010, determining the date and cause of death using official state mortality records. In our sample, the annual suicide rate among all HMO members (including non-patient members) did not change over time, whereas the annual suicide rate in the general population of the state of Michigan increased significantly. Importantly, suicides actually decreased among HMO members who received specialty mental health services, whereas suicides increased among HMO members who accessed general medical services but not specialty mental health services.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Coffey: The most important finding from our study is that, during a time when suicides increased in the general state population and also increased among HMO members who accessed general medical services but not specialty mental health services, suicides actually decreased among HMO members who received specialty mental health services. This dramatic and sustained reduction in suicide is associated with our Perfect Depression Care Program, a quality improvement initiative launched in 1999.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Coffey: The Perfect Depression Care Program’s audacious goal of pursuing “zero suicides” has tremendous social traction. The cultural and clinical applications of this goal must be spread and evaluated in other samples. In fact, just this week, the Deputy Prime Minister of the UK called for the adoption of “zero suicides” across the entire National Health Service (NHS)—it is terribly exciting.
Coffey M, Coffey C, Ahmedani BK. Suicide in a Health Maintenance Organization Population. JAMA Psychiatry. Published online January 21, 2015. doi:10.1001/jamapsychiatry.2014.2440.