Mental health remains a significant area of concern in healthcare, especially after the pandemic. Universal screening tools, such as suicide risk assessment, have become a vital resource. One of the best ways to normalize mental health screening is by integrating it into your clinical electronic health record (EHR) workflow. However, with the influx in risk assessments, is your staff confident and prepared to handle the needs that arise? And does your organization have the infrastructure required to support those needs?

While telehealth has alleviated part of the burden for providers, it has also exposed many ways technology can create barriers to care, especially for communities who are already at a disproportionate risk for suicide and addiction. So, how can we better coordinate care across the illness-wellness continuum? Join Danny Gladden and Dr. Sarah Matt as they discuss the progress and opportunities to support mental health and improve suicide prevention.

Guests:

Danny Gladden, director of behavioral health and social care, Oracle Health

Dr. Sarah Matt, vice president of product strategy, Oracle Health

Hear them talk about:

• Education and training for physicians regarding suicide assessment and prevention treatment (2:00 )
• Suicide screening assessments and lack of staff resourcing and infrastructure to meet those needs (4:15 )
• Crisis intervention training for first responders and the increased availability of mental health first aid (11:15 )
• Telehealth doesn’t solve access to care issues—there’s still a gap in equity and barriers to care (13:00 )
• Benefits of behavioral health data collected on digital record (15:15 )
• Moving toward a consumer-focused patient experience (17:20 )
• Suicide prevention resources (19:18 )

Learn more about Oracle Inpatient and Outpatient Behavioral Health solutions

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Episode Transcript:

00;00;00;00 - 00;00;30;09

Danny Gladden:

You're listening to Perspectives on Health and Tech, a podcast by Oracle, where we have conversations on creating a connected healthcare world where everyone thrives. Hi there. I'm Danny Gladden, clinical social worker, director of behavioral health and social care here for Oracle. Dr. Matt, so glad you are here.

Dr. Sarah Matt:

Thank you, Danny. I'm so excited. You know, when it comes to suicide prevention, I think there's so many problems that we could talk about, but I think there's also solutions and things we can do next.

 

00;00;30;16 - 00;01;06;28

Danny:

So I'm excited that we're talking about this topic today. Yeah. And, you know, I think we've made some great progress. And I say we as the collective, we myself, I'm a clinical social worker that practices in mental health services. I've actually ran one of the National Suicide prevention lifelines, but suicide prevention takes all of us. And so, you know, I'm actually just curious, you know, you're a physician—think about your preparation into sort of medical school and residency.

 

00;01;06;28 - 00;01;26;15

And you know what does what did your preparation look like as a physician assessing for and treating suicide risk?

Sarah:

So I went to med school a long time ago, I will say, But when it comes to training, it was very traditional. So four years of med school. And then I did my residency in general surgery and my fellowship in Burns.

 

00;01;26;17 - 00;01;56;05

So I'd say that when you think about structured learning for mental illness, it was pretty scared. Most of it was around inpatient mental health services. So that's the rotations that we did in medical school. Now there was the small bits and pieces you may have gotten on your primary care rotation, but it really wasn't a focus. Now today are unclear how the clinical rotations are going and how the medical schools have changed their training.

 

00;01;56;12 - 00;02;19;17

But I would say that for the generations of doctors that are in my age category, it definitely wasn't something that was highly stressed.

Danny:

Yeah, you know, in the last couple of years, I get invited from time to time to come in and speak to first or second year medical students, particularly on the subject of suicide assessment, suicide prevention, collaborative safety planning.

 

00;02;19;17 - 00;02;58;19

And I, I think that structurally we've come a long way in normalizing the assessment of suicide risk. We have built it into much of our clinical workflows. The Joint Commission has guidance on how on how we assess for suicide risk. But I think even maybe where there is some competence that's been gained, there's still a gap in competence, particularly because of our own fears around, oh, if I ask someone about their suicide risk, what will I do with the information they provide me?

 

00;02;58;19 - 00;03;28;02

And particularly I think about our community access hospitals it at 2 a.m. who are sort of dealing with folks with limited resources, limited specialty consultations and whatnot. And so we celebrate universal screening tools such as the Columbia Suicide severity rating scale or many other really great evidence based, validated tools. But I know that we have a long, a long way to go.

 

00;03;28;02 - 00;03;54;21

And so as we think about September Suicide Prevention Awareness Month, we think about the physicians and the nurses and those and quality and compliance who are working to manage risk within a within a hospital health system. What are you seeing best practices from a technology perspective in how folks are leveraging technology to assess for and prevent suicide?

 

00;03;54;24 - 00;04;18;18

Sarah:

So it's hard to say best practices because I think we can still do a lot better. A lot of times everyone at the administrative level of a hospital system recognizes the importance from a regulatory perspective, from a compliance perspective for universal screening for suicide. And a lot of times this kind of shows up as an extra forum for the nursing staff on intake and things like that.

 

00;04;18;20 - 00;04;37;14

I think some of the things that are missing are the why and the importance. And so in a system where nurses, doctors and all the rest of the staff are highly strained, sometimes it's difficult to do another form. The other thing I had mentioned is that a lot of times this burden is put again on medical assistance and nurses.

 

00;04;37;21 - 00;05;02;21

The providers rarely do these screens themselves, and I think that oftentimes they might not know exactly what the screening is or how useful it can be. So for their patients, where they may have a potential and or a diagnosis to have some sort of depression, anxiety, etc., there's things that they can use. There's tools that are available and they may not have all of those at their disposal.

 

00;05;02;23 - 00;05;57;11

Danny:

Yeah, again, back to the community access hospital or the Alaska village that's using a health aide, for example. I think about that 2:00 in the morning assessment that the sort of mandatory requirement in policy to assess for suicide risk and the patient sort of reporting some level of suicidal thoughts and the provider, the nurse, the health aide in Nome, Alaska, wanting desiring to do what's best to keep the patient safe, but also have limited resources to be able to, you know, get that get that individual true specialty care.

 

00;05;57;13 - 00;06;47;01

And so, you know, celebrate universal screening. But also worry about actual the what happens on the other side of a positive screening. Is it possible that we are unintentionally over hospitalizing folks with the best of intentions or over incarcerating folks with the best of intentions to keep to keep patients safe and to keep the community safe because of lack of available responsiveness from trained mental health professionals who can a dig deeper into assess, assessing and understanding is there a true lethality risk or is this someone who has what we might call morbid ideation?

 

00;06;47;01 - 00;07;18;00

You know, if I didn't wake up tomorrow, that would be okay. B