Division of Behavioral Health (DBH) Case Study
What are the trends relating to youth suicides? Are there particular "cluster" areas that indicate some type of intervention may be needed? What about Methamphetamine issues? Is this an issue among the population the IHS serves? How can we determine how big the problem is and where the problems may be occurring? How can we obtain additional resources to deal with these serious health issues?
These were some of the questions and issues the Division of Behavioral Health (DBH) had to address. While many of these events listed are documented in the local Resource Patient Management System (RPMS) Behavioral Health (BH) package, it was difficult to compile a "national" picture of these issues. However, a "national" picture was needed to determine the scope of these issues and advocate for additional resources to address them.
The DBH partnered with the Indian Health Performance Evaluation System (IHPES) program to develop its first ever DBH "data mart" to assist with tracking and reporting of these issues. The data is also used to advocate for additional resources. Although still considered to be a "version 1" application, the DBH data mart contains numerous pre-programmed reports relating to Suicidal events documented on the "Suicide Report Form" (SRF). The SRF is contained in several RPMS packages, including the Behavioral Health package. The SRF is a tool that allows providers to document a suicidal event such as a suicide ideation with plan and intent, attempted suicide and completed suicides. The SRF does not contain patient level data but contains data specific to the suicidal event such as method used, contributing factors, previous attempts and other information useful for program purposes. SRF data is electronically exported from local RPMS systems to National Programs in Albuquerque, NM. Once received, the IHPES program builds, manages and maintains a national Suicide database that drives the reports in the BH data mart. National and area behavioral health leadership then have access to a number of aggregated reports specific to SRF data, including the number of suicide completions.
To address the issues related to Methamphetamine, the IHPES program utilizes the National Data Warehouse (NDW) project to extract aggregated data regarding patient encounters (visits) and unique patient counts (no patient details). These aggregated Methamphetamine related reports are also part of the DBH data mart.
The data mart has been the primary tool used by the DBH to report to Congress on these health issues and advocate for additional resources based upon "actual data". As a result, the IHS received $16,391,000 outlined in H.R. 1105 Omnibus Appropriations Act of 2009 for the "methamphetamine and suicide prevention initiative". The DBH plans to expand the data mart to include other issues relating to Domestic Violence, Alcohol and Substance Abuse and additional information to support the Methamphetamine initiative.