If you've seen the photos of crumbling Detroit buildings that are being circulated lately, you'd probably expect the whole city to be full of miserable, despairing people, a place where a suicide rate of zero is unthinkable. Think again! Detroit is struggling but not nearly as badly as those photos suggest, and this Crain's article on the Henry Ford Health System that serves southeast Michigan suggests that "perfect" depression care is entirely possible even in an area that's going through tough times:
"The bigger issue was this culture change that we eventually implemented which simply did not accept the notion that people would kill themselves, the idea that zero would be our goal," says Ed Coffey, a physician who is vice president at the Henry Ford system and CEO of its behavioral health services division. The division has a staff of about 500 and provides mental health and substance-abuse services through its integrated delivery system of two hospitals and 10 clinics that serves Southeast Michigan and adjacent states. "That to me was the biggest thing and the key lever that allowed us to accomplish the success we had," he said.
...The Perfect Depression Care initiative includes six major tactics: commit to "perfection" (zero suicides) as a goal; develop a clear vision of how each patient's care will change; listen to patients regarding their care redesign; conceptualize, design and test strategies for improving patient partnership, clinical practice, access to care and information systems; implement relevant measures of care quality, assess progress and adjust as needed; and communicate the results.
Within the first four years of the program, the annual rate of patient suicides in the behavioral health services department dropped 75 percent to about 22 per 100,000 -- the average rate between 2002 and 2005 -- from 89 suicides per 100,000 at the baseline in 2000, according to an April 2007 article in the Joint Commission Journal on Quality and Patient Safety. In the past two years, or the last 10 consecutive quarters, the department has not seen one patient suicide.
Clearly other mental health treatment professionals need to look into this system and consider ways to learn from its success.