Background
Rationale
Objectives
Methods/design
Intervention
Framework
Pillar 1: development and implementation of a monitoring system with decision aid
Domain | Question |
---|---|
In the past month | 1. Did you have thoughts of being better off when you were dead or did you wish you were dead? |
2. Did you want to hurt yourself? | |
3. Did you have thoughts about suicide? | |
4. Did you make suicide plans? | |
5. Did you attempt suicide? | |
In life | 6. Did you have thoughts of being better off when you were dead or did you wish you were dead? |
Clinical impression | 7. Is there any acute danger in the behaviour of the person? |
Pillar 2: providing swift access
Pillar 3: positioning nurse care managers according to collaborative care
Pillar 4: providing one-year telephone monitoring
Target population
Procedure of the intervention
Step 1: registration in the monitoring system
Step 2: first contact with the crisis care professional
Step 3: follow-up monitoring
Setting
Step-wise implementation
Scientific evaluation
Hypotheses
Study design
Stepped wedge trial design
Public health impact evaluation
Intervention integrity evaluation
Allocation
Outcomes
Primary outcome: completed suicides
Secondary outcome: Suicide attempts
Exploratory process measure: suicidal ideation
Exploratory process measure: suicidal behaviour in SMHI patients
Public health impact
Dimension & definition | SUPREMOCOL pillar | Variable | Data source |
---|---|---|---|
Reach | |||
“Proportion of the target population that participated in the intervention” [43] | Pillar 1: monitoring system | • The number (+ characteristics) of chain partners that collaborate in the system versus the number of chain partners that have been approached for collaboration | • Monitoring system • Project group logs |
• The number (+ characteristics) of SMHI’s that collaborate in the system versus the number of SMHI’s that have been approached for collaboration | • Monitoring system • Project group logs | ||
Pillar 2: swift access | • The number of SMHI’s which are considering swift access versus the total number of participating SMHI’s | • Project group logs • SMHI | |
Pillar 3: collaborative care | • The number of SMHI’s which are considering to work according to the collaborative care model versus the total number of participating SMHI’s | • Project group logs • SMHI | |
Pillar 4: 12 months follow up | • The number of SMHI’s which are considering to provide 12 months follow up versus the total number of participating SMHI’s | • Monitoring system • SMHI | |
Efficacy | |||
“Success rate if implemented as in guidelines; defined as positive outcomes minus negative outcomes” [43] | Pillar 1: monitoring system Pillar 2: swift access Pillar 3: collaborative care Pillar 4: 12 months follow up | • Changes (both positive and negative) in primary and secondary outcome measures (suicidal behaviour), as described in the Methods section | • National and regional health records • PHQ-9 • SIDAS • Monitoring system |
• Experiences of patients and professionals regarding facilitating or hindering factors, as described in the Methods section | • Online surveys • Regular meetings | ||
Adoption | |||
“Proportion of settings and practices that will adopt this intervention” [43] | Pillar 1: monitoring system | • The number (+ characteristics) of chain partners that made use of the monitoring system versus the number of chain partners who have received an account to this system | • Monitoring system |
• The number (+ characteristics) of SMHI professionals that made use of the monitoring system versus the number of SMHI professionals who have received an account to this system | • Monitoring system | ||
Pillar 2: swift access | • The number of SMHI departments that have the intention to provide swift access versus the total number of participating SMHI departments | • SMHI | |
Pillar 3: collaborative care | • The number of SMHI nurses that have the intention to work according to the collaborative care model versus the total number of SMHI nurses in the SMHI treatment departments | • SMHI | |
Pillar 4: 12 months follow up | • The number of SMHI professionals that have the intention to provide follow up contacts versus the total number of SMHI professionals who received an account to the monitoring system | • SMHI | |
Implementation & Maintenance | |||
Implementation “Extent to which the intervention is implemented as intended in the real world” [43] Maintenance “Extent to which a program is sustained over time” [43] Implementation and Maintenance comprise the same variables, however, Maintenance will be measured at nine months. | Pillar 1: monitoring system | • The number of successful registrations in the monitoring system versus the total number of people attempting suicide (and were in need of an ambulance ride) | • Monitoring system • Ambulance records |
• The number of first contacts that actually took place versus the number of eligible persons for a first contact | • Monitoring system | ||
• The number of days, after the day on which the first contact should have taken place, the SMHI professional tried to contact the registered person | • Monitoring system | ||
• The number of days, after the day on which the first contact should have taken place, the first contact between the registered person and the SMHI professional actually took place | • Monitoring system | ||
Pillar 2: swift access | • The number of crisis assessments or psychiatric consults that were provided by the SMHI professionals versus the total number of crisis assessments or psychiatric consults that were indicated | • Monitoring system | |
• The number of swift accesses to care that were arranged by the SMHI professionals versus the total number of swift accessses that were indicated | • Monitoring system | ||
• The number of clinical admissions that were arranged by the SMHI professionals versus the total number of admissions that were indicated | • Monitoring system | ||
• The number of people that was referred to their general practitioner by the SMHI professionals versus the total number of people that needed to be referred to their general practitioner | • Monitoring system | ||
Pillar 3: collaborative care | • The number of SMHI professionals that are involved as case managers versus the total SMHI professionals that have an account to the monitoring system | • Project group logs | |
• The number of contacts with the general practitioner by the SMHI professionals versus the total of contacts with the general practitioner that were indicated | • Monitoring system | ||
• The number of contacts with the psychiatrist by the SMHI professionals versus the total of contacts with the psychiatrist that were indicated | • Monitoring system | ||
Pillar 4: 12 months follow up | • The number of eligible persons for a follow-up monitoring contact versus the number of follow-up monitoring contacts that actually took place | • Monitoring system | |
• The number of days, after the day on which the follow-up monitoring contact should have taken place, the SMHI professional tried to contact the registered person | • Monitoring system | ||
• The number of days, after the day on which the follow-up monitoring contact should have taken place, the follow-up monitoring contact between the registered person and the SMHI professional actually took place | • Monitoring system |