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many factors may be contributing, includ-
ing high rates of drug abuse, stress and social
isolation. It’s an expensive problem too. At-
tempted and completed suicides cost the U.S.
up to $94 billion per year in lost work and med-
ical expenses.
But a new approach is starting to yield posi-
tive results. For all the disparate reasons peo-
ple die by suicide, they tend to have something
in common : research suggests that 83% visit
some kind of doctor in the year before their
death. So health care facilities are logical places
to prevent suicide.
Hospitals and behavioral- health centers
are now redesigning their practices to include
research- backed interventions that have been
studied for years but haven’t, until now, been
widely used. In a world of high-tech, high-
cost medicine, the new protocols for treat-
ing suicidal patients are surprisingly straight-
forward. They include thoroughly screening
people, often with the help of electronic health
records, in order to target those at risk; col-
laborating with patients to write safety plans
to help them cope with suicidal episodes;
quickly treating a person’s suicidal thoughts
and behaviors rather than waiting to treat any
under lying mental illness first; removing le-
thal means like guns (which are used in nearly
half of all suicides and 69% of suicides by vet-
erans in the U.S.) from patients’ homes; and
supportively following up with patients via
letters or phone calls in the days and weeks
after they leave care, which is when many sui-
cides happen.
One Of the biggest Obstacles health
systems face in preventing suicide is losing
touch with people when they’re vulnerable.
In most U.S. hospitals, a person who arrives
at an emergency room after a suicide attempt
is generally hospitalized, stabilized and, once
deemed to be at lower risk, discharged with
guidance to follow up with a mental- health
professional. But many don’t take that advice.
Even under less acute circumstances—when
they’re receiving routine care—people fall
through the cracks.
The new best practices emphasize putting
people on the grid and not letting go. Few
places do it as well as Centerstone, a large
community mental- health center based in
Tennessee that obsessively follows up with
patients. By reprogramming its digital health-
records system, Centerstone made screening
for suicide risk mandatory; patients who re-
spond a certain way are automatically des-
ignated at risk and seen more frequently. If
one of these patients doesn’t show up for an
appointment and can’t be reached within a
few minutes, a 24/7 crisis team is pinged.
“They’re gonna come after you—in a loving,
kind, gentle way, but they’re going to pull out
all the stops to make contact with you so that
we know that you’re not in any kind of major
crisis,” says Becky Stoll, vice president for cri-
sis and disaster management for Centerstone.
One of these routine phone calls reached a
patient as he was standing on the edge of a
bridge ready to jump; the caller persuaded
him to return to the clinic. Within two years
of making this change and others in 2014,
the rate of suicide deaths at Centerstone had
dropped by 64%.
Using electronic health records may even
predict who’s at risk for suicide attempts or
deaths in the wider population. In October,
Kaiser Permanente will begin using a com-
bination of patients’ health records and their
Thomas
Reardon
A watch that can
read your mind
A man wearing what
looks like a chunky black
wristwatch stares at a tiny
digital dinosaur leaping over
obstacles on a computer
screen before him. The
man’s hands are motionless,
but he’s controlling the
dinosaur—with his brain.
The device on his wrist is
the CTRL-kit, which detects
the electrical impulses
that travel from the
motor neurons to the arm
muscles almost as soon
as a person thinks about
a particular movement. “I
want machines to do what
we want them to do, and I
want us to not be enslaved
by the machines,” says
Thomas Reardon, CEO and
co-founder of CTRL-Labs,
the device maker. The
hunched-over posture
and fumbling keystrokes
of the smartphone era
represent “a step backward
for humanity,” says
Reardon, a neuroscientist
who, in a past life, led the
development of Microsoft’s
Internet Explorer. The
technology could open up
new forms of rehabilitation
and access for patients
recovering from a stroke or
amputation, as well as those
with Parkinson’s disease,
multiple sclerosis and
other neurodegenerative
conditions, Reardon says.
ÑCorinne Purtill
HEALTH CARE
I N N OVAT O R S
NADIYA NACORDA FOR TIME
