Collaborative Care Model Offers Success in Reducing Suicide Risk, New Report Finds

For the last 3 years, the suicide rate in the US has remained consistently high, which highlighted the urgent need for intervention. A report published today supports the integration of behavioral health into primary care through the Collaborative Care Model (CoCM).¹

The majority of individuals who die by suicide visited a primary care provider within the year of their death, with nearly half of those visits occurring in the month prior to death. The CoCM model, which facilitates coordinated care between primary care providers, behavioral health specialists, and care managers, has become a recognized approach to addressing this gap between mental health and primary care.²

New report further supports collaborative care model in bridging gap between behavioral health and primary care.

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The report, supported by the American Foundation for Suicide Prevention (AFSP), The Jed Foundation, Shatterproof, and The Bowman Family Foundation, reviews findings from 3 recent studies that collectively underscore the potential of CoCM to lower suicide risk across diverse patient populations and health systems.³

CoCM Reduces Suicide Risk in Primary Care Patients in 3 Studies

In the first study, researchers followed patients identified as “at risk” for suicide, finding that over half (56%) experienced reduced risk after receiving care through CoCM.⁴ From November 2021 to December 2023, Concert Health enrolled nearly 30,000 patients in the CoCM program, with 5856 flagged for elevated suicide risk via tools like the Patient Health Questionnaire-9 (PHQ-9) and the Columbia Suicide Severity Rating Scale (C-SSRS). The analysis focused on 3809 patients who completed care episodes, revealing that 76% of those who remained in the program for 6 months or more showed improvement in their risk levels.

The CoCM's structure, which includes regular clinical touchpoints and ongoing symptom tracking, allows for real-time adjustments to care plans. High-risk patients received more intensive engagement than those labeled “at risk.” The program proved effective across various populations, with statistical analysis indicating that increased interaction with care managers correlated with greater reductions in suicide risk.

The second study, led by researchers at the Perelman School of Medicine at the University of Pennsylvania, found similarly encouraging results.⁵ Among 368 patients identified as “at risk” across 19 primary care practices in 2 states, 52% saw a decrease in suicidal risk, alongside reductions in depression and anxiety symptoms.

Suicidal ideation declined from 11% to 7% over the course of care, with severity rarely worsening. Both depression and anxiety scores improved significantly for patients with and without suicidal thoughts, though the degree of improvement varied by race, ethnicity, and age. Patients who began care with suicidal ideation had higher depression scores throughout treatment, but longer participation in CoCM was linked to greater reductions in symptoms.

The third and largest study, from Kaiser Permanente in Washington, examined more than 228,000 patients who received key elements of CoCM.⁶ The analysis found that population-based suicide care in primary care settings, which included enhanced depression screening, suicide risk assessment, safety planning, electronic medical record (EMR) decision support, and performance monitoring, can significantly reduce suicide attempts. Conducted across 19 primary care practices within a major health system, the study evaluated outcomes for over 480,000 adult patients between 2015 and 2018.

Compared with a control group of 255,789 patients, the intervention group experienced a 25% reduction in combined suicide attempts and deaths within 90 days of a primary care visit (4.5 vs 6.0 per 10,000 patients) and led to a higher rate of documented safety planning (38.3 vs 32.8 per 10,000 patients). Following these findings, Kaiser Permanente is now scaling the full CoCM model across all eight of its regional markets.

A Scalable, Evidence-Based Solution

The CoCM is recognized for its effectiveness in integrating behavioral health—including treatment for substance use disorders—into primary care, the report emphasized.¹ By embedding mental health professionals directly into the primary care setting and facilitating systematic follow-up and measurement-based care, the model not only improves outcomes but can also reduce overall healthcare costs.

“These studies confirm the value of the Collaborative Care Model for saving lives and helping people at risk for suicide,” Jill Harkavy-Friedman, PhD, senior vice president of Research at AFSP, said in a statement. “At AFSP, we advocate for a healthcare system that is designed to ensure mental health is as important as physical health and that it is accessible to all. CoCM shows a viable path to strengthen our healthcare system toward this end. It’s time to embrace this model of care, and CoCM can be a powerful tool in our public health response to suicide.”

Upcoming Webinar: May 8

To further explore the model’s impact, the report sponsors will host a webinar, Reducing Suicide Risk Through Primary Care: How the Collaborative Care Model Can Help Save Lives, on May 8 at 2:00 PM ET.

References

1. Large reductions in suicide risk, attempts and deaths demonstrated by three “real world” studies in primary care. News release. The Bowman Family Foundation; Shatterproof. April 10, 2025. https://www.globenewswire.com/news-release/2025/04/10/3059132/0/en/Large-Reductions-in-Suicide-Risk-Attempts-and-Deaths-Demonstrated-by-Three-Real-World-Studies-in-Primary-Care.html

2. Grossi G. Collaborative care approaches ranked by depression outcomes in primary care. AJMC. March 28, 2025. Accessed April 9, 2025. https://www.ajmc.com/view/collaborative-care-approaches-ranked-by-depression-outcomes-in-primary-care

3. Large reductions in suicide risk, attempts and deaths demonstrated by three “real world” studies in primary care. Shatterproof; The Bowman Family Foundation. Published online April 10, 2025. https://filesbff.org/CoCM_Suicide_Risk_Reduction.pdf

4. Little V, Hardy C, Green B, Fuller S. Addressing suicide risk: a study of dose response in collaborative care. JG Research & Evaluation. July 2024. https://jgresearch.org/wp-content/uploads/2024/08/Addressing-Suicide-Risk.pdf

5. Khazanov GK, Wolk CB, Lorenc E, et al. Change in suicidal ideation, depression, and anxiety following collaborative care in the community. BMC Prim Care. 2024;25(1). doi:10.1186/s12875-024-02494-2

6. Angerhofer Richards J, Cruz M, Stewart C, et al. Effectiveness of integrating suicide care in primary care. Ann Intern Med. 2024;177(11):1471-81. doi:10.7326/M24-0024