The World Health Organization (2018) defines the private sector as organizations and individuals that provide product and health care services that are not controlled by the government (p.6). The private sector can then be broken down into various subcategories, the most know non-profit and for profit, formal and informal then also into domestic or foreign. In the last ten years the public and private sector have collaborated to create the National Action Alliance for Suicide Prevention (Action Alliance), their partnership works on advancing the policies and interventions of the National Strategies for Suicide Prevention. Their main objective being to make suicide a national priority. The two main priority areas of suicide that this group focuses on is transformation of healthcare systems in order to reduce suicides and change in conversations surrounding suicide and suicide preventions. The other areas of focus are to improve financing, standards of care, clinical workforce trainings and education, crisis services and resources as well as care transitions.
The Action Alliance set out to improve the suicide care in the healthcare systems by supporting the implementation of “zero suicide initiative”. Zero suicide is a quality improvement and safety framework on suicide that is set to improve suicide care by making changes to leadership mindset, organization policies and overall improvement in practices and outcome measures. The Action alliance recently met with representative from some of the top United States insurance companies to engage them in discussions on the role of health plans in suicide prevention (Action Alliance, 2019).This resulted in five recommendations they all collaborated on that would create consistency in health plans to include, education, training of health plan staff, adoption of clinical practice guidelines on suicide, work groups for data collection, develop and lead collaborative pilots projects in state and delivery systems, and track cost of intentional injury claims internally. Engaging the health care plan companies will help with reimbursement and set guidelines for providers to follow to give the best treatment to suicidal patients.
Another area of focus that is very important and forward thinking in policy is the transformation care for the suicidal patient that just discharged and is waiting to be connected to the proper follow up providers. The risk for these patients is just as high as when they came in due to going back to their environments that may be the stressor or feelings of guilt or embarrassment in what they did and how they felt. The Action Alliance make it essential that the patients have care in the transformation period from hospital to their own providers. Although, the Action Alliance partners with public sector their objectives and goals for suicide are innovative and advanced.
References
Henry Ford TV (n.d.). Zero suicide healthcare call to action. Retrieved from https://www.youtube.com/watch?v=tyfdN-4nJZQ
The Action Alliance. (2019). Best Practices in Care Transitions for Individuals w Suicide Risk: Inpatient Care to Outpatient Care. Retrieved from https://www.youtube.com/watch?v=6FHfYT8nJwU&feature=youtu.be
The Action Alliance. (2019). Healthcare. Retrieved from https://theactionalliance.org/healthcare
World Health Organization. (2018). Technical series: On primary health care. Retrieved from https://www.who.int/docs/default-source/primary-health-care-conference/private-sector.pdf?sfvrsn=36e53c69_2
Suicide does not have an age limit 
The introduction of your post is informative, with the explanation of private and public sectors. While reading your post I realized that all different topics may have pros and cons of the private/public sector innovations, and each topic may have more of one than the other. For example, it seems like your post reflects a positive interaction between the two, whereas my post highlights the negative effects of intermingling between the two. Thank you for highlighting the importance of monitoring and assisting patients through the transitional stage, as I believe this time is crucial for many different issues and diseases.
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Reading your blog and watching the video you provided helped to reinforce the idea of care transitions being a time of great risk in my mind (1). I can see how suicidal patients discharged back to their environments that produce triggering stressors can be dangerous. In my work with people who inject drugs, this same thought process is also true. People are at the most risk for overdose following periods of reduced tolerance (ie: detoxification, release from incarceration, or cessation of treatment)2.
I spent many clinical rotations throughout our program in correctional health where I witnessed firsthand patients with both substance use disorder AND suicidality. Safety was maintained through different policies of the facility, but I often wondered what happened when these patients were released. Often, inmates spend time detoxing in isolation cells because they are deemed a danger to themselves or others. However, not every inmate who is booked remains in the facility to serve time. After 24-48 hours and their initial appearance in front of the judge, they are released. I was shocked to see they were released with very few resources! And a 100% of them were not in cognitive positions to understand their mental health resources due to intoxication or to sever mental illness. From a SUD perspective they were released with Narcan but for their suicidality, I didn’t see very many resources being offered. I believe release from incarceration is a “care transition” of sorts for suicidal inmates as well. The Action Alliance video spoke of some great steps to care for suicidal patients during their care transition but didn’t elude to how those steps apply to release from incarceration.
Do you know of any resources for this? Particularly for inmates in AZ?
References
1.The Action Alliance. (2019). Best Practices in Care Transitions for Individuals w Suicide Risk: Inpatient Care to Outpatient Care. Retrieved from https://www.youtube.com/watch?v=6FHfYT8nJwU&feature=youtu.be
2. World Health Organization. (2020). Management of substance abuse.
Retrieved from https://www.who.int/substance_abuse/information-sheet/en/
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I am not sure what all is offered in Arizona for inmates that face dual diagnosis upon release. Most inmates had case manager prior to going to jail that at times is the resource to check in on them and connect them with mental health providers and clinic. Some social workers in the prison system send out referrals to agencies that have integrated care such as Bayless and Southwest. There is also drug court that at times makes mandatory for them to get mental health care as part of being released.
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Suicide is such a difficult problem to solve. Its origins can manifest from so many different situations and experiences that it is really hard to pin down a specific cause or preventative measure. In the military we had bi-annual suicide awareness training as well as seminars with both suicide survivors and relatives of people who committed suicide. I also have known 5 people who have committed suicide. For the people I know the reasons varied significantly, and the signs were not always there. Two stemmed from divorces where they lost their kids after combat deployments. One was a team member who witnessed the death of his team leader and felt overwhelmed with guilt. The other two left no notes and gave no signs, but had been on multiple combat deployments and had recently returned. For me the haunting part is only one of the five had any outward signs of depression. I truly hope that more private sector advocates and policy group interaction can begin to truly make headway on this very real issue.
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