title: Population health outcome models in suicide prevention policy.
abstract: BACKGROUND
  Suicide is a leading cause of death in the U.S. and results in immense suffering and significant cost. Effective suicide prevention interventions could reduce this burden, but policy makers need estimates of health outcomes achieved by alternative interventions to focus implementation efforts.
  
  
  OBJECTIVE
  To illustrate the utility of health outcome models to help in achieving goals defined by the National Action Alliance for Suicide Prevention's Research Prioritization Task Force. The approach is illustrated specifically with psychotherapeutic interventions to prevent suicide reattempt in emergency department settings.
  
  
  METHODS
  A health outcome model using decision analysis with secondary data was applied to estimate suicide attempts and deaths averted from evidence-based interventions.
  
  
  RESULTS
  Under optimal conditions, the model estimated that over 1 year, implementing evidence-based psychotherapeutic interventions in emergency departments could decrease the number of suicide attempts by 18,737, and if offered over 5 years, it could avert 109,306 attempts. Over 1 year, the model estimated 2,498 fewer deaths from suicide, and over 5 years, about 13,928 fewer suicide deaths.
  
  
  CONCLUSIONS
  Health outcome models could aid in suicide prevention policy by helping focus implementation efforts. Further research developing more sophisticated models of the impact of suicide prevention interventions that include a more complex understanding of suicidal behavior, longer time frames, and inclusion of additional outcomes that capture the full benefits and costs of interventions would be helpful next steps.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. Electronic address: frances.lynch@kpchr.org.
authors.forename: Frances L
authors.initials: FL
authors.lastname: Lynch
mesh_terms: D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006291:Health Policy; D006801:Humans; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011159:Population Surveillance; D013406:Suicide, Attempted / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology; D000092864:Suicide Prevention