Treating suicidal risk in a post-healthcare reform era
| DOI | https://doi.org/10.1108/JACPR-10-2014-0143 |
| Pages | 167-178 |
| Published date | 13 July 2015 |
| Date | 13 July 2015 |
| Author | David A Jobes,Maureen Elizabeth Bowers |
| Subject Matter | Health & social care,Criminology & forensic psychology,Aggression, conflict & peace |
Treating suicidal risk in a post-healthcare
reform era
David A. Jobes and Maureen Elizabeth Bowers
Dr David A. Jobes is Professor
of Psychology and Professor
Maureen Elizabeth Bowers is a
Graduate Apprentice, both at
the Department of Psychology,
The Catholic University of
America, Washington, District
of Columbia, USA.
Abstract
Purpose –The purpose of this paper is to fully consider the potential changes in clinical suicide prevention
that may evolve after the passing of the Patient Protection and Affordable Care Act (ACA). The authors argue
that it is wise to anticipate demand for suicide-specific evidence-based treatments (EBTs) moving forward.
The authors outline current best practices in clinical suicide prevention, and describe the Collaborative
Assessment and Management of Suicidality (CAMS) as an example of how a suicide-focussed EBT can
adapt to some predicted changes.
Design/methodology/approach –This conceptual paper first presents an overview of the main effects of
ACA within the behavioral health care (BHC) system. Next, the authors review contemporary approaches
to the treatment of suicidal patients, as well as current treatment limitations. The authors present
CAMS as a model of a suici de-focussed EBT tha t holds promise for use in the post-ACA era. To close,
the authors discuss anticipated changes in suicide treatment and illustrate that CAMS is adaptable to
these changes.
Findings –ACA mandates several changes: implementation of EBTs, better preventative care, integrated
treatment models, and improved healthcare administration. A central effect of ACA in BHC is the increased
use of EBTs. Therefore effective EBTs for suicide prevention are described.
Originality/value –Anticipating how ACA will affect clinical suicide prevention is necessary, as it is
historically a very challenging area of treatment within BHC and a significant public health concern. This paper
highlights the importance of the use suicide-specific EBTs.
Keywords Suicide, Evidence-based practice, CAMS, Clinical psychologists, Healthcare reform,
Suicide prevention
Paper type Conceptual paper
Introduction
The passage of the Affordable Care Act (ACA; Public Law No: 111-148, March 23, 2010) set in
motion numerous an d significant cha nges to the US health care system. Prima ry changes
include the expect ation that all citize ns obtain health insu rance coverage, an in creased focus
on preventative healthcare, a movement to integrate healthcare, and extended treatment
coverage (Rosenbaum, 2011). Within behavioral health care (BHC), it is expected that there will
be an increased supply of patients as well as an increase in demand for evidence-based
treatments (EBTs ). This is because in surers are require d to provide increa sed coverage for
BHC, both mental health and substance use services under the Mental Health Parity and
Addiction Equity Act (MHPAE) (United States Department of Labor, 2012). Also, more people
will obtain insurance and consequent access to BHC services as a result of ACA (Buck, 2011).
The expectation that treatments increasingly will need to be evidence based is demonstrated
by the creation of the Patient-Centered Outcomes Research Institute (PCORI) (Selby et al.
2012), a direct outcome of the ACA. The proliferation of EBTs is a central aim of PCORI, which
primarily funds comparative clinical effectiveness research and disseminates the results
(Clancy and Collins, 2010).
Received 20 October 2014
Revised 8 January 2015
Accepted 8 February 2015
DOI 10.1108/JACPR-10-2014-0143 VOL. 7 NO.3 2015, pp. 167-178, © Emerald Group Publishing Limited, ISSN 1759-6599
j
JOURNAL OF AGGRESSION, CONFLICTAND PE ACE RESEARCH
j
PAG E 16 7
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