teen boy sits in hospital bed speaking with two female health providers

Transition: Supportive Care & Contacts

Transitions are a high period of risk for individuals experiencing suicidal thoughts. During this time, individuals may encounter significant barriers to accessing follow-up care, such as a lack of awareness about available resources or receiving resources that do not adequately address their specific needs. 

Many patients may also face increased isolation and a lack of social support following a crisis. Research indicates that 50-70% of individuals who have attempted suicide do not engage in or maintain follow-up care after being discharged from the hospital (Hamel 2023). These risks occur across many settings including from the emergency department to home, hospital to home, outpatient to home.

Help People Move Through Care

Engaging youth and families around planning for transitions can reduce risk. In your clinical setting, there are multiple ways to reduce risk associated with transitions. This can include caring contacts as well as scheduling appointments and warm handoffs. These interventions have been shown to be effective strategies to engage patients and families around risk factors and address barriers.

Caring contacts are brief check-in opportunities with youth and families after discharge from a level of care. Methods include post-cards, phone calls, and text messages. Developing a standardized approach to caring contacts can be essential in normalizing routine engagement with youth and families after discharge from the emergency department or hospital. This can include creating workflows, utilizing the EMR, and partnerships with agencies to support with close follow-up.

More Resources

Association of Timely Outpatient Mental Health Services for Youths After Psychiatric Hospitalization With Risk of Death by Suicide

Fontanella CA, Warner LA, Steelesmith DL, Brock G, Bridge JA, Campo JV. JAMA Network Open, 2020, 3(8).

doi: 10.1001/jamanetworkopen.2020.12887

 

Caring Transitions - A Care Coordination Intervention to Reduce Suicide Risk Among Youth Discharged From Inpatient Psychiatric Hospitalization.

Gryglewicz K, Peterson A, Nam E, Vance MM, Borntrager L, Karver MS. The Journal of Crisis Intervention and Suicide Prevention, 2023, 44(1), 7–13. https://doi.org/10.1027/0227-5910/a000795 

 

Evaluating the prevalence of four recommended practices for suicide prevention following hospital discharge

Chitavi SO, Patrianakos J, Williams SC, Schmaltz SP, Ahmedani BK, Roaten K, Brown GK. The Joint Commission Journal on Quality and Patient Safety, 2024, 50(6), 393-403.

DOI: 10.1016/j.jcjq.2024.02.007

 

Caring contacts for suicide prevention: A systematic review and meta-analysis

Skopp NA, Smolenski DJ, Bush NE, Beech EH, Workman DE, Edwards-Stewart A, Belsher BE. Psychological Services, 2023 20(1), 74-83.

DOI: 10.1037/ser0000645

 

Enhancing Care Transitions for Youth in Acute Care Settings With Automated Caring Contacts

Ackerman J, Thomas G, Masood F, Camacho E. Journal of the American Academy of Child & Adolescent Psychiatry, 2023, 62(10).

DOI: 10.1016/j.jaac.2023.07.234

 

Development and Implementation of Postdischarge Text Messages to Adolescents With Suicidal Thoughts and Behaviors Through Caring Contacts: Implementation Study

Thomas GV, Camacho E, Masood FA, Huang Y, Valleru J, Bridge JA, Ackerman J. JMIR Pediatrics and Parenting, 2024 13(7:e51570).

DOI: 10.2196/51570

 

Comparative effectiveness of two-way caring contacts texts vs one-way caring contacts texts vs enhanced usual care to reduce suicidal behavior in adolescents and adults: Protocol for the SPRING pragmatic randomized controlled trial

Radin AK, Brown SP, Shaw J, Fouts T, McCue E, Skeie A, Pierce H, Flint H, Biss M, Sandoval D, Chase K, Davis J, Austin G, Chan KCG, Fruhbauerova M, Ratzliff A, Walton M, Bronner J, McCutchan PK, Comtois KA. Journal of American College of Emergency Physicians Open, 2024, 5(5).

DOI: 10.1002/emp2.13322