Increasing Early Detection of Youth Behavioral Risk, Improving Care Delivery and Addressing Suicide in Primary Care Settings

High-profile catastrophes and humbling prevalence of suicides have prompted widespread national acknowledgement of the disturbing scope of the suicide epidemic. National, federal and professional representatives mobilized to take action by funding the development of a long-term, collaborative tragedy prevention strategy. In 2008, the Garrett Lee Smith (GLS) Youth Suicide Prevention in Primary Care program was established and awarded by the United States Substance Abuse and Mental Health Service Agency (SAMHSA) to screen and address comprehensive behavioral risks, inclusive of suicide, in primary-care venues amongst youth ages 14-24.   

The Wright Center engaged as a GLS Youth Suicide Prevention in Primary Care program participant concurrent with its immersion in primary care practice medical home redesign efforts through the Pennsylvania Chronic Care Initiative.  The Wright Center’s ongoing practice transformation efforts converged integration of Electronic Health Record (EHR) Meaningful Use standards and Chronic Care Model guidance initially using diabetes as a population of focus to drive care delivery redesign.

The team integrated Behavioral Health Screens (BHS) into workflow without a significant amount of additional (perceived or actual) staff effort. To encourage buy-in, medical assistants, resident physicians and providers at The Wright Center were educated about the GLS program and trained as BHS champions. The medical assistants led workflow integration by providing a tablet and coaching to engage each patient at their annual well visit, placing emphasis on confidentiality. Patients completed the screen privately and results were summatively assessed at the point of care, immediately available for provider review. 

In 2010, The Wright Center for Primary Care Mid Valley completed 1043 total BHS during young adult well visits and by 2016, had spread workflow and processes into its second program phase, effectively screening 3988 young adults.