title: National pathways for suicide prevention and health services research.
abstract: BACKGROUND
  In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research.
  
  
  METHODS
  Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals.
  
  
  RESULTS
  Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention.
  
  
  CONCLUSIONS
  Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide.
authors.affiliation: Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan. Electronic address: bahmeda1@hfhs.org.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Ahmedani
authors.affiliation: Department of Counseling and School Psychology, University of Massachusetts-Boston, Boston, Massachusetts.
authors.forename: Steven
authors.initials: S
authors.lastname: Vannoy
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration; D003625:Data Collection / Q000379:methods; D006297:Health Services Accessibility; D006302:Health Services Research / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control*; D014481:United States; D000092864:Suicide Prevention