Suicide risk remission in collaborative care: a large-scale observational study

IntroductionPrimary care settings represent a critical opportunity for suicide prevention, as many individuals who die by suicide visit primary care providers in their final month of life. The Collaborative Care Model (CoCM) offers a structured approach to behavioral health treatment in primary care...

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Main Authors: Carol Hardy, Virna Little, Brandn Green
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1584753/full
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author Carol Hardy
Virna Little
Brandn Green
author_facet Carol Hardy
Virna Little
Brandn Green
author_sort Carol Hardy
collection DOAJ
description IntroductionPrimary care settings represent a critical opportunity for suicide prevention, as many individuals who die by suicide visit primary care providers in their final month of life. The Collaborative Care Model (CoCM) offers a structured approach to behavioral health treatment in primary care, but research on its effectiveness for suicide risk management is limited. This study examined how clinical variables (days enrolled, clinical touchpoints, psychiatric consultations) relate to suicide risk outcomes in CoCM, and how these relationships are moderated by initial depression severity.MethodsData from 3,599 patients with suicide risk flags who completed CoCM treatment were analyzed using ordinal logistic regression. Changes in suicide risk level from intake to discharge were categorized as improved, unchanged, or regressed.ResultsLonger enrollment (OR=1.432, p<.001) and more clinical touchpoints (OR=2.584, p<.001) predicted improved outcomes. Higher baseline depression scores predicted poorer outcomes (OR=0.741, p<.001) but showed significant interaction with days enrolled. More psychiatric consultations (OR=0.813, p<.001) were associated with risk regression, likely reflecting appropriate escalation of complex cases.DiscussionCoCM shows promise for suicide risk management in primary care, with sustained engagement and frequent clinical contact improving outcomes. Results suggest treatment intensity should be tailored to initial depression severity.
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spelling doaj-art-04d0169103cd49da9d174cb3ffffeae52025-08-20T03:28:18ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.15847531584753Suicide risk remission in collaborative care: a large-scale observational studyCarol Hardy0Virna Little1Brandn Green2JG Research & Evaluation, Bozeman, MT, United StatesConcert Health, San Diego, CA, United StatesJG Research & Evaluation, Bozeman, MT, United StatesIntroductionPrimary care settings represent a critical opportunity for suicide prevention, as many individuals who die by suicide visit primary care providers in their final month of life. The Collaborative Care Model (CoCM) offers a structured approach to behavioral health treatment in primary care, but research on its effectiveness for suicide risk management is limited. This study examined how clinical variables (days enrolled, clinical touchpoints, psychiatric consultations) relate to suicide risk outcomes in CoCM, and how these relationships are moderated by initial depression severity.MethodsData from 3,599 patients with suicide risk flags who completed CoCM treatment were analyzed using ordinal logistic regression. Changes in suicide risk level from intake to discharge were categorized as improved, unchanged, or regressed.ResultsLonger enrollment (OR=1.432, p<.001) and more clinical touchpoints (OR=2.584, p<.001) predicted improved outcomes. Higher baseline depression scores predicted poorer outcomes (OR=0.741, p<.001) but showed significant interaction with days enrolled. More psychiatric consultations (OR=0.813, p<.001) were associated with risk regression, likely reflecting appropriate escalation of complex cases.DiscussionCoCM shows promise for suicide risk management in primary care, with sustained engagement and frequent clinical contact improving outcomes. Results suggest treatment intensity should be tailored to initial depression severity.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1584753/fullsuicide preventioncollaborative caresuicide care pathwaysuicide remissionsuicide treatmentdepression
spellingShingle Carol Hardy
Virna Little
Brandn Green
Suicide risk remission in collaborative care: a large-scale observational study
Frontiers in Psychiatry
suicide prevention
collaborative care
suicide care pathway
suicide remission
suicide treatment
depression
title Suicide risk remission in collaborative care: a large-scale observational study
title_full Suicide risk remission in collaborative care: a large-scale observational study
title_fullStr Suicide risk remission in collaborative care: a large-scale observational study
title_full_unstemmed Suicide risk remission in collaborative care: a large-scale observational study
title_short Suicide risk remission in collaborative care: a large-scale observational study
title_sort suicide risk remission in collaborative care a large scale observational study
topic suicide prevention
collaborative care
suicide care pathway
suicide remission
suicide treatment
depression
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1584753/full
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