Implementation strategy to increase clinicians' use of the caring letters suicide prevention intervention. 2023

Mark A Reger, and Susan M Jegley, and Shelan A Porter, and Jack A Woods, and Lynne Liu, and Jesse D Markman, and Sara J Landes
VA Puget Sound Health Care System.

Caring Letters is recommended in multiple best practice guidelines; however, the Caring Letters intervention has not been widely implemented. The process of tracking, scheduling, and mailing letters for multiple patients over many months may represent a significant barrier for busy clinicians. This evaluation examined whether the use of centralized administrative support (Centralized Caring Letters; CCL) was associated with increased utilization of the intervention. These procedures were tested in the Department of Veterans Affairs (VA) Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET) program. In REACH VET, VA clinicians are routinely asked to consider Caring Letters as one option for veterans identified as at-risk. In this evaluation, clinicians at two VA facilities were offered assistance in the tracking, preparation, mailing, and documentation of Caring Letters for veterans they chose to enroll in CCL. The utilization of Caring Letters increased more than 14-fold after CCL was implemented. In the year that preceded CCL, 3% of REACH VET veterans were sent Caring Letters at the two sites; this increased to 43% of cases after the implementation of CCL (45% at Site 1 and 41% at Site 2). In qualitative interviews with providers, clinicians described Caring Letters as beneficial and stated that the centralized features of the program were helpful. Caring Letters were discontinued for 30% of enrolled veterans, often because of a bad address (9% of enrolled) or relocation (8% of enrolled). Although there are barriers for the use of Caring Letters, CCL was associated with a very large increase in the use of Caring Letters. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

UI MeSH Term Description Entries
D006703 Ill-Housed Persons Persons without adequate housing or without permanent residence. The concept excludes nomadic peoples. Homeless Persons,Homeless Shelters,Shelterless Persons,Shelters for Homeless Persons,Street People,Unhoused Persons,Homelessness,Homeless Person,Homeless Shelter,Ill Housed Persons,Ill-Housed Person,People, Street,Person, Homeless,Person, Ill-Housed,Person, Shelterless,Person, Unhoused,Persons, Homeless,Persons, Ill-Housed,Persons, Shelterless,Persons, Unhoused,Shelter, Homeless,Shelterless Person,Shelters, Homeless,Unhoused Person
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000092864 Suicide Prevention Specific strategies for averting suicides. These include mental HEALTH PROMOTION and monitoring PSYCHOLOGICAL WELL-BEING and other intervention programs targeting susceptible individuals. Suicide Awareness,Awareness, Suicide,Prevention, Suicide,Suicide Preventions
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014493 United States Department of Veterans Affairs A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position. United States Veterans Administration,Veterans Administration (U.S.),Veterans Affairs (U.S.),United States Veterans' Administration,United States. Dept. of Veterans Affairs,Veterans Administration
D014728 Veterans Former members of the armed services. Veteran

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