The Follow-Up Project

New vendor transition

Hospital Follow-Up Project services transitioned to a new vendor as of September 2024. A team from the University of Colorado School of Medicine Division of Community, Population, and Public Mental Health now provides Hospital Project Follow-Up services. 

• Colorado School of Medicine Division of Community, Population, and Public Mental Health. (website)

Relaunch

• The full Follow-Up Project Relaunch was on November 4, 2024.
• The Follow-Up Project Relaunch Webinar provides more information about what the re-launch means for enrolled sites.
  • Follow-Up Project Relaunch Webinar. (video)
• Enrolled sites were asked to launch the new web enrollment form.
• Nina Brathwaite, the Hospital Follow-Up Program (HFUP) Program Manager was in direct contact with enrolled sites to provide the resources and links needed for a seamless relaunch implementation.
• Links to pertinent training and flyers were added to the online web referral form to centralize resources.
• A training video is in the works and will be distributed to sites previously enrolled in the Follow-Up Project.

Second Wind Fund

• The Second Wind Fund which connects youth ages 19 and younger who are at risk for suicide to therapists as part of the Follow-Up Project, will continue.

Enrollment

• Sites not currently enrolled in the Follow-Up Project can email Jazmin Murguia, Hospital Follow-Up Project Coordinator jazmin.murguia@state.co.us.to learn more about enrolling.

Questions

For more information, email Suicide Prevention Follow-Up Project Coordinator Jazmin Murguia at jazmin.murguia@state.co.us.

Suicide is a public health issue in Colorado. Colorado's Hospital Follow-Up Project addresses a critical need for follow-up services in our system of care.

Collaborative Effort

• Colorado’s Hospital Follow-Up Project is a collaboration between CDPHE’s Office of Suicide Prevention; the University of Colorado School of Medicine Division of Community, Population, and Public Mental Health; the Second Wind Fund; and health systems across the state.

Funding

• Supported by grant funding from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) the Follow-Up Project seeks to provide telephonic caring contacts to clients discharging from an emergency department or inpatient psychiatric unit. 

Eligibility

• Patients are eligible to participate after experiencing suicidal ideation, behavior, and attempt, self-harm, substance use, opioid use, or overdose event, regardless of intent. 

Patient cost

• These services come at no cost to enrolled sites and patients across Colorado.

• Follow-Up services are telephonic caring contacts offered to clients discharged from an emergency department (ED) after experiencing a suicidal ideation, behavior, and attempt, self-harm, substance use, opioid use, or overdose event, regardless of intent.

Increased risk

• Individuals are at an increased risk for suicide and suicide attempts:
  • The risk of a suicide attempt or death is highest within 30 days of discharge from an ED or inpatient psychiatric unit. (Newton, MA: Suicide Prevention Resource Center website, PDF)
  • Between 2008 and 2017, the rate of emergency department (ED) visits related to suicidal ideation or suicide attempts increased for all age groups. (Healthcare Cost and Utilization Project website, PDF)
  • In 2017, 64.4 percent of ED visits related to suicidal ideation or suicide attempts resulted in an admission to the hospital or transfer to another facility versus 17.1 percent for all other ED visits. (Healthcare Cost and Utilization Project website, PDF)
  • Up to 70% of patients who leave the ED after a suicide attempt never attend their first outpatient appointment. (Newton, MA: Suicide Prevention Resource Center website, PDF)
  • In the month after patients leave inpatient psychiatric care, their suicide death rate is can be up to 300 times higher than the general population’s. Their suicide risk remains high for up to three months after discharge and for some, their elevated risk endures after discharge. (National Action Alliance for Suicide Prevention, PDF download available)

Positive results

• Research indicates that follow-up services for individuals recently discharged from the ED have positive results for both consumers and providers of mental health services. (Washington, DC: Education Development Center, Inc, PDF)
• Telephonic follow-up has been shown to improve client outcomes, reduce the likelihood of reattempt, and increase the connection with helping resources post-discharge. Follow-up protocols have also been shown to reduce the need for future hospitalizations by reducing barriers to accessing services in a timelier manner. Additionally, follow-up care has been shown to be cost-effective and prevent suicides. 
• The Follow-Up Project is a key element in the continuum of care for clients experiencing suicidality. (The Joint Commission Journal on Quality and Patient Safety , PDF)

Pilot program

• Learn more about the results of the Follow-Up Project Pilot Program that was conducted July 1, 2015-October 31, 2017.
  • Implementing an Emergency Department Telephone Follow-Up Program for Suicidal Patients: Successes and Challenges. (The Joint Commission Journal on Quality and Patient Safety, PDF)

Screening

• The Follow-Up Project model involves hospital staff screening people who are preparing to leave an inpatient or emergency department for suicide risk, referring them to and encouraging them to participate in the program, and conducting a “warm handoff” to hotline clinicians over the phone. 

Follow-up

• Once hotline staff have an individual’s consent and contact information, they will reach out to them multiple times within the first 24 to 48 hours after discharge, and then regularly (typically weekly) for a month or longer as needed.

Services

• Follow-up services are free caring, non-demand contacts made by Follow-up Specialists who offer support through: 
  • safety assessment
  • harm reduction
  • resource linkage
  • collaborative goal setting

Peer specialists

• University of Colorado School of Medicine Division of Community, Population, and Public Mental Health is staffed by crisis and peer specialists, ensuring that your clients are placed into trained, caring hands. 
• Follow-Up Specialists have varying areas of expertise, including: 
  • clinical-based support
  • peer-based support
  • clinical opiate-specific support
  • veteran peer support

Facility eligibility

• All Colorado Emergency Departments are eligible to participate.

Client eligibility

The Follow-up Project was initially designed to serve clients experiencing suicidality. However, with additional funding, client eligibility has been increased to include anyone struggling with:

• suicidal ideation
• suicidal behavior or attempts
• self-harm
• substance use
• opioid use 
• overdoses, regardless of intent