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Tijdschrift voor Psychiatrie 62 (2020) 6, 439 - 447


Practice variation in the field of suicide prevention in Dutch mental healthcare

K. Setkowski, R. Gilissen, G. Franx, J.K. Mokkenstorm, A. van den Ouwelant, A.J.L.M. van Balkom

background Previous studies found that the implementation of service guideline recommendations can significantly reduce the number of suicides in mental healthcare. Important barriers to suicide prevention guideline implementation are a lack of professionals’ knowledge and competence towards the suicide prevention guideline.
aim To assess professionals’ knowledge of, competence in, and adherence to the suicide prevention guideline in twelve Dutch specialist mental healthcare institutions.
method In this study, professionals working at crisis teams and outpatient care teams from each of the 12 participating mental healthcare institutions in the network of supranet Care were invited to fill in a questionnaire examining professionals’ knowledge of, competence in, and adherence to the suicide prevention guideline (N = 400). Results were analyzed with multilevel regression analysis and adjusted for confounding.
results Although professionals scored high on knowledge, competence, and adherence towards the guideline, they did not know to what extent the guideline was implemented within their own team. Outpatient care teams scored significantly lower on professionals’ knowledge and reported lower levels of competence. Furthermore, we found significantly higher scores on adherence to the guideline for professionals in crisis teams compared to outpatient care teams. Healthcare professionals also reported practice variation within and across Dutch mental healthcare institutions. conclusions Practice variation within and across teams and mental healthcare institutions is undesirable. To reduce this variation, professionals and mental healthcare institutions should share best-practices and learn from each other how the quality of care for suicidal patients can be optimized.

keywords guideline, mental healthcare, quality of care, suicide