Payer-provider partnership can play a key role in suicide prevention

On average, about 130 Americans die of suicide every day… Since the outbreak of COVID-19, there have been concerns that stressors caused by the pandemic, such as social isolation, economic problems, depression and limited access to health services, could exacerbate suicidal behavior. Although the Centers for Disease Control and Prevention found that overall suicide rate declined during COVID-19, rates increased among youth and people of color, the latter of whom were disproportionately affected by the pandemic.

However, suicide remains a problem for all racial, ethnic and socioeconomic groups, and as a result, payers have the opportunity to change their approach to suicide prevention through partnerships with providers and local communities.

Nearly 50% of people who died by suicide had visited a primary health care provider within the previous 30 days, and over 80% had visited a behavioral health specialist or primary health care provider in the year before they died. However, in a survey conducted Association of Low Income Clinicians (ACU), “One in five health care providers have never been trained in how to recognize warning signs that patients may be at increased risk of suicide, and 32% were unsure of their ability to treat patients with suicidal thoughts or behavior.”

Because suicide is associated with several risk factors and variables that influence a person’s stress levels, payers and service providers must work together to address physical, mental, socioeconomic, and other influencing factors. Seventy percent of behavioral health problems are treated in a primary care room, so it is essential that these providers have the tools to identify, treat, and refer participants to specialized care as needed. With this in mind, Centene partnered with ACU to develop and deliver a suicide prevention training program for over 1,700 primary care providers and staff in 16 states on suicide risk assessment and intervention.

Payers have access to significant amounts of data and can conduct analytics to identify those at highest risk of suicide, allowing service providers to intervene early and provide appropriate assistance or referrals. By combining data with innovative technologies, payers and providers can work together to identify those at risk to help prevent suicide attempts and behavior. Through the use of machine learning, we are able to create and implement models that accurately identify risk levels for individuals, allowing service providers to effectively intervene. We have combined data science, clinical experience of psychiatrists and psychologists, and business analysts to create an analytic model that identifies the participants at the highest risk of suicide. Our clinically trained account managers can then proactively coordinate needed services for those at risk, which not only saves lives but also reduces hospital admissions, avoidable emergency department visits, and overall medical costs and mental health costs.

In addition to prevention and detection, providers can also help those who have attempted suicide through interventions such as clinical treatment and outreach. Research shows that by providing follow-up care and other support, the number of suicides in the country may decrease by 20%… From teaching and digital / teletherapy to higher levels of healthcare management, healthcare teams can tailor care to each individual to provide compassionate support. Payers and service providers can also use tools and resources, such as communicating with the care management team during a change of care and supporting families of those who have committed suicide.

In particular, social workers are often at the forefront and therefore play a critical role in suicide prevention, but many report feeling unprepared and uncomfortable. Evidence-based training can help social workers identify signs of distress and engage participants in the care they need. Care programs should also be culturally sensitive and aim to identify and then address the social determinants of health. Social workers are well aware of these unique challenges. Risk factors for suicide include social isolation, financial stress, unemployment, and other SDOHs. In addition, adverse childhood experiences such as abuse, neglect, and substance use can increase the risk of suicide. Addressing these complex issues will increase the effectiveness of advocacy and intervention.

Payers and service providers can play a critical role in reducing unnecessary loss of life and harm to family, friends and community members. Through improved access to high-quality personalized suicide prevention care, partnerships with social service agencies and organizations, and the use of advanced technology to better identify those at risk, together we can improve the quality of life of those in dire straits.

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