Measurement-Based Care Can Improve Screening and Treatment of Suicidality Among High-Risk Groups 

Suicide affects individuals across all demographics, but certain groups — in particular, LGBTQ+ individuals, veterans, minorities and older men — face disproportionately higher risks due to unique vulnerabilities and challenges. Addressing this disparity requires a nuanced approach that includes measurement-based care (MBC) screening and care, a data-driven methodology that can help detect suicide risk early and tailor interventions effectively.  

High-risk groups and their unique challenges 

LGBTQ+ individuals, especially youth, are at a significantly higher risk of suicide compared to their heterosexual peers, due to societal stigma, discrimination, family rejection and a lack of acceptance. The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health reported that 41% of LGBTQ youth seriously considered attempting suicide in the past year.  

Veterans also face challenges that significantly increase their risk of suicide, including post-traumatic stress disorder (PTSD), depression and the difficulties of transitioning back to civilian life. The U.S. Department of Veterans Affairs (VA) found that in 2020, veterans accounted for 13.7% of all suicides among U.S. adults, despite comprising only 8.4% of the adult population. 

Minority populations, including Black, Indigenous and other people of color face systemic challenges that increase their risk of suicide. Suicide rates among Black youth are rising faster than any other racial or ethnic group, while Indigenous peoples experience a suicide rate 3.5 times higher than the general U.S. population. 

The group at greatest risk of suicide is older men, particularly those aged 75 and above, with a rate of 40.8 per 100,000 in 2021. Factors such as social isolation, physical illness, chronic pain and bereavement contribute to this distressing statistic. Given the extraordinary risk among these individuals, there is a pressing need for Medicare and Medicare Advantage (MA) plans to integrate more comprehensive mental health services in the future. The Mental Health Parity Act, which mandates that insurance plans provide equal coverage for mental and physical health conditions, is a crucial step in ensuring that older adults and their caregivers have access to the necessary resources moving forward. 

“By incorporating MBC into mental health care, clinicians can enhance their ability to detect suicidality early and tailor interventions to address specific risk factors more effectively.”

John Langlow, MD, MBA – Medical Director

The role of MBC in suicide prevention

Measurement-based care, which involves regularly assessing patient symptoms, treatment progress and outcomes using standardized, validated tools, can be an important ally in the fight against suicide. MBC provides health care providers with real-time data to inform clinical decisions, allowing for adjustments in treatment plans based on individual patient needs. By incorporating MBC into mental health care, clinicians can enhance their ability to detect suicidality early and tailor interventions to address specific risk factors more effectively.  

MBC improves suicidality screening and treatment among high-risk groups by: 

Enhancing Early Detection
Regular and systematic screening with validated tools can help identify individuals at risk of suicide before they reach a crisis point. This is particularly important for high-risk groups who may not always openly communicate their struggles due to stigma, discrimination or a lack of trust in health care systems. For example, LGBTQ+ youth often face societal stigma and may be hesitant to seek help. MBC can provide a structured environment where they feel safer disclosing their mental health concerns. 

Tailoring Interventions to Individual Needs
Each high-risk group has unique factors contributing to their increased suicide risk. Veterans, for instance, might struggle with PTSD and difficulty adjusting to civilian life, while older men may face isolation and physical illness. MBC allows clinicians to customize interventions based on the specific needs of each patient, ensuring that care is both relevant and effective. By continuously monitoring patient-reported outcomes, providers can adjust treatment plans to better address the evolving needs of their patients. 

Reducing Treatment Gaps
MBC helps ensure that all patients receive equitable care by standardizing assessments and reducing subjective bias in treatment decisions. This is especially important for minority populations, who often face systemic barriers to accessing mental health services. By using objective data to guide care, MBC can help bridge gaps in treatment quality and access, ensuring that minority groups receive the same level of care as other populations. 

Improving Patient Engagement and Outcomes
Regular feedback on treatment progress can empower patients, encouraging them to take an active role in their mental health care. This is particularly valuable for high-risk groups who may feel disenfranchised or skeptical about mental health services. When patients see tangible improvements in their mental health status, they are more likely to remain engaged in their treatment, reducing the risk of suicide. 

 
John Langlow, MD, MBA is a medical director at Lucet, The Behavioral Health Optimization Company.