Natural History of Suicidal Ideation: Insights from the Electronic Health Record

Suicide is the 10th highest cause of death in the US. Despite the prevalence, little is known about the experiences of people before, during, and after suicidal ideation. A new research tool, the electronic health record, presents an opportunity for behavioral health researchers to obtain objective data across time. The purpose of this study was to explore the usefulness of the electronic health record as a research tool as we seek to better understand the experiences of persons with suicidal ideation. Using the electronic health records, we conducted a retrospective chart review on 66 persons with suicidal ideation in an outpatient behavioral health clinic from September 2015 to January 2017. To be included in this study, participants were required to be adults who demonstrate suicidal ideation evidenced by a score > 0 on the Columbia Suicide Severity Rating Scale. Researchers analyzed participant’s demographics, diagnoses, medication, and frequency and interval of visits to describe participants’ progression of suicidal ideation during the study period. Using the electronic health records, we were successfully able to describe the experiences of persons with suicidal ideation. The natural progression was complex and required close monitoring, medications, and medication changes to identify the optimal medication regimen. Most participants overcame suicidal ideation, but about 40% of individuals failed to follow-up. The electronic health records efficiently and effectively described the experiences of persons with suicidal ideation. However, more research is needed to understand and improve the breadth and depth of their experiences.