Reducing suicide risk post-discharge from an inpatient unit: a quality improvement project

Abstract

Background: Individuals with suicidal ideation and mental health crises are often stabilized on an inpatient psychiatric unit. Unfortunately, the risk of suicide is 100-200 times higher in the post-discharge period (Chung et al., 2017; 2019). Lethal means restriction (LMR) can reduce suicide risk and involves limiting access to lethal means. Social supports of patients discharged from inpatient care are instrumental in LMR, but they can experience a mental health crisis from caregiving. Local Problem: Several states in the Northwestern U.S. consistently have suicide rates above the national average, with Wyoming, and Montana in the top five states for highest suicides rates (CDC, 2023). Methods: The site for this quality improvement project was an inpatient psychiatric unit in an urban location in the Northwest that accepts adult patients with all spectrums of mental illness. Interventions: An interdisciplinary discharge process change was implemented to ensure distribution of a printed suicide prevention discharge packet (SPDP) to patients. Free gun locks and medication disposal bags were provided whenever desired. The packet provides information on LMR, warning signs of suicide, locations for medication disposal, and supportive community resources. Results: At the end of week five of the project, 100% of patients received the packet and gun locks or medication disposal bags whenever desired. Conclusion: A SPDP coupled with free gun locks and medication disposal bags is an effective way of ensuring caregivers of patients discharged from inpatient care receive access to supportive resources, LMR education, and have the resources to reduce access to lethal means.