QUERI – Quality Enhancement Research Initiative

Implementing Caring Contacts for Suicide Prevention in Non-Mental Health Settings

North Little Rock, AR

Overview

Suicide rates for Veterans are higher than for the general population, and suicide prevention remains a high priority for the VA nationally and across VISNs. This is a particularly critical issue for Veterans living in rural settings, who are at greater risk for suicide. National suicide prevention initiatives and research studies have highlighted transitions in care, such as discharge from an emergency department (ED), as critical time periods to improve suicide prevention. The majority of suicides occur within 30 days after discharge from the hospital or ED, thus healthcare providers need something simple and effective to improve care during the critical transition following ED discharge.

The Caring Contacts for Suicide Prevention in Non-Mental Health Settings QUERI Partnered Implementation Initiative is working to implement an evidence-based suicide prevention intervention—Caring Contacts—in the emergency department. Caring Contacts (CC) is a straightforward intervention that involves sending patients who are suicidal brief, non-demanding expressions of care and concern over a year or more.

See a Caring Contacts sample below.

Studies of Caring Contacts have demonstrated significant reductions in suicide deaths, attempts, and ideation at one and two-year follow-up. This project will use implementation facilitation, an evidence-based implementation strategy used often in VA, to support sites in implementing Caring Contacts.

More specifically, QUERI investigators aim to:

• Spread Caring Contacts across all VA medical centers in VISN 16 and selected sites in VISNs 5, 6, 10, 12, 17, 19, 22, 23.
  • Adapt implementation tools and processes to address varying VISN and setting (e.g., urgent care center vs. emergency department) needs.
• Evaluate clinical and implementation outcomes associated with Caring Contacts spread (e.g., service utilization, suicide related behavior, and number of Veterans reached).
  • Evaluate the impact of Veteran demographic characteristics on Caring Contacts clinical and implementation outcomes (e.g., age, rural vs. urban).
• Conduct a budget impact analysis that documents cost of implementation and cost outcomes of Caring Contacts in the emergency department.
• Evaluate the role of geographic context in clinical and implementation outcome patterns.

Anticipated Impacts

The Caring Contacts for Suicide Prevention in Non-Mental Health Settings QUERI Partnered Implementation Initiative plans to implement this suicide prevention intervention in 26 sites across VISNs 5, 6, 10, 12, 16, 17, 19, 22, 23.

Corresponding Principal Investigator: Sara J. Landes, PhD, contact at Sara.Landes@va.gov. Dr. Landes also is part of HSR&D’s Center for Mental Healthcare and Outcomes Research (CeMHOR), the South Central MIRECC, and the Behavioral Health QUERI in North Little, Rock, AR.

Operations Partners: VA’s Office of Mental Health and Suicide Prevention; Leadership in VISNs 5 (VA Capitol Health Care Network), 6 (VA Mid-Atlantic Health Care Network), 10 (VA Healthcare System of Ohio), 12 (VA Great Lakes Health Care System), 16 (South Central VA Health Care Network), 17 (VA Heart of Texas Healthcare Network), 19 (VA Rocky Mountain Network), 22 (VA Desert Pacific Healthcare Network), 23 (VA Midwest Health Care Network); and VA’s Program Evaluation Resource Center.