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Tijdschrift voor Psychiatrie 60 (2018) 9, 581 - 591


Data-guided learning from suicidal incidents by using KEHR SUICIDE. A practice example in a Dutch mental health care facility

M.H. de Groot, R.T. Kleppe, E. Pols, R.F.P. de Winter, A.J.F.M. Kerkhof

background Specific and systematic data on health care providers’ behaviour is needed to futher improve the care provided to suicidal patiënts in mental health care facilities.
method Explorative observational study of all suicidal incidents (n=50) that occurred in a Dutch mental health care facility over a one year period. Incidents were evaluated using kehr suicide, a questionnaire that assesses to what extent health care providers’ conduct was compliant to the suicide practice guideline in the context of patients’ suicidal behaviour. Associations between health care providers’ and patients’ features and guideline compliant behaviours of health care providers were calculated by logistic regression models.
results Health care providers showed less guideline compliant behaviour when the patient had a psychotic, substance abuse or development disorder or had no axis 1 disorder. A positive association was found between guideline compliant behaviour and the extent to which the incident had been expected. conclusion Guideline compliant behaviour of mental health care providers appears to be related to the axis 1 disorder of patients in a Dutch mental health care facility. Still, the application of guideline compliant behaviour concerning suïcide incidents shows room for improvement. kehr suicide is shown to be a helpful tool for multidisciplinary evaluation of suicidal incidents as it provides specific, ready-made information by which mental health care facilities can guide, examine and adjust suicide prevention policy. The outcomes provide hypotheses that may be examined in future research.

keywords evaluation, quality improvement, suicide, suicide attempt