Zero Suicide Framework
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.
- 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.
- 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 firstname.lastname@example.org)
- Continuously monitor and annually revisit the Organizational Self-Study, Workforce Survey, and Work Plan to record progress and continue to strive for excellence.
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.
The Utah Zero Suicide Learning Collaborative provides training, examples of successful implementation, and a peer network of other agencies implementing Zero Suicide in Utah. Contact Andrea Hood to participate.
Leading Zero Suicide Efforts
- Blank Assessment and Plan
- Sample Announcement Letter to Staff
- Why Transformation Efforts Fail
- Organizational Self Study
- 2018 Utah Learning Collaborative – Meeting Slides
- Joint Commission Sentinel Event Alert
- Identifying Those At Risk
- Centerstone Standard Operating Procedure
- Collaborative Screening And Assessment
Engaging Patients At Risk
- Stanley Brown Safety Plan Template
- Adding a Pathway To Your Treatment
- Texas Zest Pathway to Care
- Zero Suicide In Healthcare – My Version
- Engage – Suicide Care Management Plans
2018 Zero Suicide Summit
- UNI Presentation
- Four Corners BH Presentation
- Davis BH Presentation
- Measuring & Evaluating Suicide Prevention
- Creating and Sustaining System Transformation
- Training for Meaningful Practice Transformation
- From Planning to Lessons Learned
Transitions In Care
Evaluating And Improving Efforts
- Safety Planning PDF and link to safety planning guide
- Organizational Self-Assessment PDF
- Workforce Survey Downloadable PDF
- U of U Crisis Resources
- Suicide Prevention Lifeline
- The Trevor Project
- Emergency Department Guide
- Toolkit for Primary Care PDF
- American Foundation for Suicide Prevention