Implementation of Structured Suicide Risk Screening in a State Physician Health Monitoring Program.

Abstract

Background: This study examined the implementation of structured suicide risk screening by a large state physician health monitoring program (PHP).

Methods: Physicians (n = 363; 87 women; 44.78 years-old, SD = 13.75) were screened for suicide risk with the Columbia Suicide Severity Rating Scale (C-SSRS) at PHP intake and at 2-weeks, 3-months, 1-year, 2-years, 3-years after initiating monitoring, and following any sentinel events. The PHP response was recorded at each timepoint.

Results: At intake, female physicians reported higher current (p = .025, Cramer's V = .178) and lifetime suicide risk (p = .010, Cramer's V = .163) compared to male physicians. Physicians monitored for substance use disorders (SUD) were more likely to deny any lifetime suicide risk than those monitored for co-occurring SUD and psychiatric disorders (p = .017, Cramer's V = .171), and had lower rates of "moderate" lifetime suicide risk than those monitored for psychiatric disorders only (p = .017, Cramer's V = .171). The PHP offered behavioral health referrals for physicians reporting "low" risk (n = 2) plus safety measures for those with "moderate" (n = 2) and "high" risk (n = 1). One physician reporting "low" risk and four physicians reporting "high" risk were already in-treatment. At 2-weeks and 3-months into monitoring, suicide risk remained "very low" (99.4% and 98.8%) or "low." At 1-year, risk was "very low" for 99.3% of physicians, with two at "moderate" risk. At 2 and 3 years, 100% reported "very low" suicide risk. No suicides occurred among monitored physicians.

Conclusion: PHPs offer support to mitigate suicide risk among physicians. The observed decrease in suicide risk across monitoring may reflect the recovery processes that monitoring is intended to support.