Addressing Suicide Research Gaps: Understanding Mortality Outcomes
Presenter
Jane Pearson, Ph.D.
Division of Services and Intervention Research
Goal
Health care system data (e.g., suicide attempt events) needs to be linked to mortality data so that a more accurate picture of the risks for, and burden of suicide among those seen in care is known. Specifically, data are needed on the type, severity, and timing of suicide predictors. In addition to improving our national knowledge of the burden of suicide, these are essential ‘metrics’ for both public and private care providers/insurers, who increasingly will be seeking improvements to drive down suicide events in their systems.
Rationale
NIMH continues to address research gaps identified in the 2014 Prioritized Research Agenda for Suicide Prevention. The U.S. military and Veterans Health Administration have reported on suicide mortality outcomes among those seen in their respective health care systems. This information spurred actions in those systems to improve care. In the absence of U.S. civilian linked data, researchers rely on Canadian and European estimates of mortality risk for civilians seen in health care settings. Recent NIMH research suggests that mortality risk after Emergency Department (ED) presentation in the U.S. is probably higher than the European estimates. Reports of reduction in men’s longevity due to overdose and suicide deaths have put U.S. mortality data in the spotlight. The U.S. needs mortality outcomes for individuals seen in U.S. health care settings, to understand the real burden of suicidal behavior. These are essential ‘metrics’ for both public and private care providers/insurers who are seeking care improvements to drive down suicide events in their systems. Research incentives are needed to support access to appropriate data sources, and develop teams with expertise (e.g., prior successful data linkage research) to get this effort completed efficiently.
This initiative will encourage research in the following areas:
- Among the largest public data sources (e.g., Medicaid and Medicare/CMS; Agency for Healthcare Research and Quality‘s Healthcare Cost and Utilization Project [HCUP]), seek proximal as well as longer term precursors of mortality outcomes among various cohorts (e.g., defined by care access patterns; demographic characteristics).
- Examine mortality-linked CMS and HCUP data at both the state and national level to track state and federal quality improvement progress in reducing suicide burden.
- Facilitate linkage of private/commercial insurance health care data with mortality outcomes to enable research on patterns and predictors of suicide and other mortality in this population.
- Examine precursors and their association to suicide and other mortality outcomes to probe whether targeting particular precursors would reduce multiple types of mortality.