Zero Suicide Framework

What is Zero Suicide?

The foundational belief of Zero Suicide is that suicide deaths for individuals under care within health and behavioral health systems are preventable. It presents both a bold goal and an aspirational challenge. Zero Suicide is rooted in culture change and quality improvement. Health systems have shown that it works in reducing suicide deaths for people in care. This has been successful in other systems and can be successful in your treatment setting.

For health care systems, this approach represents a commitment:

  • To patient safety, the most fundamental responsibility of health care
  • To the safety and support of clinical staff, who do the demanding work of treating and supporting suicidal patients

The programmatic approach of Zero Suicide is based on the realization that suicidal individuals often fall through the cracks in a sometimes fragmented and distracted health care system. A systematic approach to quality improvement in these settings is both available and necessary.

The challenge and implementation of Zero Suicide cannot be borne solely by the practitioners providing clinical care. Zero Suicide requires a system-wide approach to improve outcomes and close gaps.

After researching successful approaches to suicide reduction, the Action Alliance’s Clinical Care and Intervention Task Force identified seven essential elements of suicide care for health and behavioral health care systems to adopt:

  • Lead – Create a leadership-driven, safety-oriented culture committed to dramatically reducing suicide among people under care. Include survivors of suicide attempts and suicide loss in leadership and planning roles.
  • Train – Develop a competent, confident, and caring workforce.
  • Identify – Systematically identify and assess suicide risk among people receiving care.
  • Engage – Ensure every individual has a pathway to care that is both timely and adequate to meet his or her needs. Include collaborative safety planning and restriction of lethal means.
  • Treat – Use effective, evidence-based treatments that directly target suicidal thoughts and behaviors.
  • Transition – Provide continuous contact and support, especially after acute care.
  • Improve – Apply a data-driven quality improvement approach to inform system changes that will lead to improved patient outcomes and better care for those at risk.
Implementing the Zero Suicide Framework is a challenging system-wide undertaking. Technical assistance is available at no cost by emailing Andrea Hood. You can also use this step by step guide:

  • Form a Zero Suicide leadership committee with representation from clinical and administrative staff with authority to carry out recommendations
  • Complete the Organizational Self-Study
  • Complete the Zero Suicide Workforce Survey to assess clinician skill and confidence in suicide intervention
  • Create a Zero Suicide Work Plan for embedding components of Zero Suicide into the policy and structure of your entity, based off of the results of the Organizational Self-Assessment and Workforce Survey. Key components may include:
    i. Suicide screening policy including when and how screening should be administered
    ii. Suicide in-depth assessment for those who screen positive for suicide risk
    iii. Suicide specific treatment and/or referral process
    iv. Follow up to manage ongoing risk
  • Participate in the Utah Zero Suicide Collaborative and Annual Summit (facilitated by
  • Continuously monitor and annually revisit the Organizational Self-Study, Workforce Survey, and Work Plan to record progress and continue to strive for excellence.

Technical assistance is available at no cost by emailing Andrea Hood. You can request one-on-one technical assistance, staff training in components of Zero Suicide; or you may participate in the Utah Zero Suicide Learning Collaborative, or Annual Summit which provide training, examples of successful implementation, and a peer network of other agencies implementing Zero Suicide in Utah.
Staff Training is an important component of Zero Suicide, and Utah law requires that mental health providers receive 2 hours of suicide prevention training per licensure period. Training should be embedded in organizational policy, be offered on a regular basis, and be tailored to the level of care that the recipient is expected to provide (e.g. more specialized and in-depth training for clinical vs front desk staff). DSAMH has compiled the following lists of recommended trainings based upon job description:

If you have any questions regarding these or would like to request an in person training, please contact Andrea Hood.
*Please note that this is not an exhaustive list of all available trainings and that Utah DSAMH does not endorse any for-profit business or training provider over another.