Journal article
Building an Integrated Data Infrastructure to Examine the Spectrum of Suicide Risk Factors in Philadelphia Medicaid
Administration and policy in mental health and mental health services research, v 50(6), pp 999-1009
01 Nov 2023
PMID: 37689586
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
While there are many data-driven approaches to identifying individuals at risk of suicide, they tend to focus on clinical risk factors, such as previous psychiatric hospitalizations, and rarely include risk factors that occur in nonclinical settings, such as jails or emergency shelters. A better understanding of system-level encounters by individuals at risk of suicide could help inform suicide prevention efforts. In Philadelphia, we built a community-level data infrastructure that encompassed suicide death records, behavioral health claims, incarceration episodes, emergency housing episodes, and involuntary commitment petitions to examine a broader spectrum of suicide risk factors. Here, we describe the development of the data infrastructure, present key trends in suicide deaths in Philadelphia, and, for the Medicaid-eligible population, determine whether suicide decedents were more likely to interact with the behavioral health, carceral, and housing service systems compared to Medicaid-eligible Philadelphians who did not die by suicide. Between 2003 and 2018, there was an increase in the number of annual suicide deaths among Medicaid-eligible individuals, in part due to changes in Medicaid eligibility. There were disproportionately more suicide deaths among Black and Hispanic individuals who were Medicaid-eligible, who were younger on average, compared to suicide decedents who were never Medicaid-eligible. However, when we accounted for the racial and ethnic composition of the Medicaid population at large, we found that White individuals were four times as likely to die by suicide, while Asian, Black, Hispanic, and individuals of other races were less likely to die by suicide. Overall, 58% of individuals who were Medicaid-eligible and died by suicide had at least one Medicaid-funded behavioral health claim, 10% had at least one emergency housing episode, 25% had at least one incarceration episode, and 22% had at least one involuntary commitment. By developing a data infrastructure that can incorporate a broader spectrum of risk factors for suicide, we demonstrate how communities can harness administrative data to inform suicide prevention efforts. Our findings point to the need for suicide prevention in nonclinical settings such as jails and emergency shelters, and demonstrate important trends in suicide deaths in the Medicaid population.
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Details
- Title
- Building an Integrated Data Infrastructure to Examine the Spectrum of Suicide Risk Factors in Philadelphia Medicaid
- Creators
- Molly Candon - University of PennsylvaniaKathleen Fox - Drexel UniversityShari Jager-Hyman - University of PennsylvaniaMin Jang - University of PennsylvaniaRachel Augustin - Drexel University, Dana and David Dornsife School of Public HealthHilary Cantiello - University of PennsylvaniaLisa Colton - Department of Behavioral Health and Intellectual Disability ServicesRebecca Drake - Philadelphia Department of Public HealthAnne Futterer - University of PennsylvaniaPatrick Kessel - Department of Behavioral Health and Intellectual Disability ServicesNayoung Kwon - University of PennsylvaniaSerge Levin - Department of Behavioral Health and Intellectual Disability ServicesBrenna Maddox - Children's Hospital of PhiladelphiaCharles Parrish - Department of Behavioral Health and Intellectual Disability ServicesHunter Robbins - Department of Behavioral Health and Intellectual Disability ServicesSiyuan Shen - University of PennsylvaniaJoseph L. Smith - Jefferson CollegeNaima Ware - Department of Behavioral Health and Intellectual Disability ServicesSosunmolu Shoyinka - Department of Behavioral Health and Intellectual Disability ServicesSuet Lim - Department of Behavioral Health and Intellectual disability Services, City of Philadelphia
- Publication Details
- Administration and policy in mental health and mental health services research, v 50(6), pp 999-1009
- Publisher
- Springer US
- Number of pages
- 11
- Grant note
- Community Behavioral Health and the Department of Behavioral Health and Intellectual Disability Services, City of Philadelphia / Community Behavioral Health and the Department of Behavioral Health and Intellectual Disability Services, City of Philadelphia
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health
- Web of Science ID
- WOS:001061728500001
- Scopus ID
- 2-s2.0-85170248363
- Other Identifier
- 991021861306404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Policy & Services
- Public, Environmental & Occupational Health