A multi-source collection of readings, tools, videos, and webinars to help you understand and implement Zero Suicide.

Displaying 1 - 15 of 180
Identify | Web

SPRC designed this guide to assist Emergency Department (ED) health care professionals with decisions about the care and discharge of patients with suicide risk. Its main goal is to improve patient outcomes after discharge. The guide helps ED caregivers answer these questions:

  • How can I effectively intervene while this patient is in the ED? 
  • Can this patient be discharged or is further evaluation needed?
  • What will make this patient safer after leaving the ED?
Engage | PDF, Web

Suicide and drug overdose deaths in the United States, regardless of age or race, have increased since 2001 and the rate of drug overdose death surpassed that of suicide in 2015 (CDC WISQARS, 2018). There are shared risk factors for suicide and substance abuse, including depression, trauma history, hopelessness, and impulsivity (SAMHSA, 2015). Research indicates that individuals who struggle with substance abuse disorders can also be at increased risk for suicide. For example, in one study, adults who abused opioids at least weekly were more likely to engage in suicide planning and attempts (Ashrafioun, Bishop, Conner, & Pigeon, 2017). Individuals who struggle with substance misuse and abuse are at higher risk for suicide, health care providers undoubtedly encounter these challenging and complex patients. Systems that have adopted a Zero Suicide framework are well suited to embed best practices and training that directly targets the impact of substance abuse on suicide.

This webinar will highlight innovative ways that health and behavioral health care organizations are changing organizational practices and providing improved care for patients with substance abuse disorders who are at heightened risk for overdose and suicide. By the end of this webinar, participants will be able to (1) identify ways to improve staff attitudes and confidence towards working with patients at risk for suicide and overdose deaths, (2) share unique patient engagement and suicide care management plan considerations for this population, and (3) describe the importance of a patient-centered perspective to treating suicide risk and overdose risk concurrently.

Transcripts available on request. Please direct requests to

Identify | Web

The Suicide Prevention Resource Center has created a seven-minute about The Patient Safety Screener (PSS-3), a tool for identifying patients in the acute care setting who may be at risk of suicide. The PSS-3 can be administered to all patients who come to the acute care setting, not just those presenting with psychiatric issues, and was developed by the University of Massachusetts Medical School. Accompanying materials provide help to administer the PSS-3, plan for patients who screen positive, and implement screening sustainably and effectively. 

Identify | Web

In this episode, Rocky Mountain MIRECC for VA Suicide Prevention speaks with Dr. Bridget Matarazzo about the VA Suicide Risk Management Consultation Program. The program has recently expanded so that anyone working with a Veteran and concerned about suicide can contact them for a free consultation. Bridget discusses the idea behind the service and the team (Hal S. Wortzel, MDSarra Nazem, Ph.D.Georgia Gerard, LCSWKaily A. Cannizzaro, PsyD, and Peter Gutierrez, Ph.D.) that provides the consultation.

Treat | Web

TreamentWorksForVets is a public information website for veterans, family members, and others interested in learning more about proven mental health treatments for veterans. The website uses easy to follow animations, creative videos, and interactive exercises to explain Cognitive Behavioral Therapy for Depression and Cognitive Behavioral Therapy for Insomnia. TreatmentWorksforVets was created by experts in veterans mental health to increase awareness of evidence-based psychotherapies and is supported by the VA Rocky Mountain MIRECC (Mental Illness Research, Education and Clinical Center) for Suicide Prevention.

Train | PDF

Adapted by the THRIVE project at the Northwest Portland Area Indian Health Board, this document can help all types of organizations understand their Zero Suicide Workforce Survey results. The document includes discussion questions and statements to guide implementing teams through a conversation about their results. 

Engage | PDF, Web

The Zero Suicide framework is based on the foundational belief that gaps in suicide care exist in sometimes fragmented and distracted health and behavioral health (HBH) systems. One population at risk for falling through these cracks is homeless individuals due to a lack of residential stability and the challenges for providers of ensuring successful transitions in care. Rates of suicide deaths among homeless individuals are approximately nine times higher than the general population (Poon et al, 2017). Findings from the most recent Annual Homelessness Assessment Report to Congress indicate that for every 10,000 people in the United States, 17 of them were experiencing homelessness (U.S. Department of Housing and Urban Development, 2017a). Significantly, 49% met the criteria for a severe mental illness and/or a chronic substance use disorder. Based on Healthcare Cost and Utilization Project (HCUP) data from 8 states, among the approximately 59,000 homeless patients who visited and were released from the ED, about 17% received care related to suicide or intentional self-inflicted injury (Sun, Karaca, & Wong (AHRQ), 2014). In a Zero Suicide approach, HBH providers should have practices in place that keep all patients at increased risk for suicide engaged in treatment, including attending to hard-to-reach populations such as homeless patients. During this webinar, presenters will share innovative and thoughtful ways they have successfully improved patient engagement and optimized safe care transitions for homeless individuals through their organizational policies and practices.

By the end of this webinar, participants will be able to (1) identify commonly experienced challenges in providing suicide care to homeless patients, (2) describe unique suicide screening, risk assessment, and safety planning considerations for this population, and (3) demonstrate how HBH organizations can establish meaningful partnerships with community organizations to augment safer suicide care practices for patients experiencing homelessness.

Transcripts available on request. Please direct requests to

Identify | Web

The Ask Suicide-Screening Questions (ASQ) Toolkit is a free resource for medical settings (emergency department, inpatient medical/surgical units, outpatient clinics/primary care) that can help nurses or physicians successfully identify youth at risk for suicide. The ASQ is a set of four screening questions that takes 20 seconds to administer. The Ask Suicide-Screening Questions (ASQ) toolkit is designed for screening youth ages 10-24 (for patients with mental health chief complaints, consider screening below age 10). The ASQ is free of charge and available in multiple languages.

Identify | Web

The Rocky Mountain MIRECC for Suicide Prevention, part of the Department of Veterans Affairs, is offering a free consultation program for any clinician and provider who works with any Veteran at risk for suicide. Consultation topics may include things like risk assessment, conceptualization of suicide risk, lethal means safety counseling, strategies for how to engage veterans at high risk, best practices for documentation, provider support after a suicide loss, and more. 

Engage | Web

Dr. Joseph Simonetti, MD, MPH, physician and suicide prevention researcher talks with the Rocky Mountain MIRECC for VA Suicide Prevention about the disproportionate role that firearms take in Veteran suicides. The conversation explores the benefits of temporary storage of firearms and dispels common misconceptions of firearm safety in the context of collaborative mental health care. Follow the link to listen to the podcast and to find supporting resources on lethal means safety for Veterans at risk for suicide.

Train | PDF

Tips and case studies from Zero Suicide implementors to help improve the response rates for your organization's workforce survey rollout.

Lead | Web

Rocky Mountain MIRECC for Suicide Prevention has released its second trilogy of Zero Suicide-related podcasts. These podcasts originated at the Bridging the Divide conference last May in Denver. 

Why and How Now Matters Now with Ursula Whiteside PhD

At the Bridging the Divide Conference we chatted with Ursula Whiteside (apologies to Ursula on my little faux pas) and she told us why Now Matters Now and how caring messages can go such a long, long way.

An Agency's Approach to Zero Suicide with Richard T. McKeon PhD, MPH

From the 2017 Bridging the Divide Conference we had a short conversation with Richard T. McKeon, Ph.D., M.P.H., Chief of the Suicide Prevention Branch for SAMHSA.

A State's Approach to Zero Suicide with Sarah Brummett MA, JD

Sarah Brummett is the Director of the Office of Suicide Prevention for the State of Colorado. Sarah discusses how the Zero Suicide system approach looks when applied to a whole state. It is amazing.

Lead | Web

This Joint Commission special report offers recommendations from a panel of experts regarding environmental hazards for providers and surveyors and what constitutes adequate safeguards to prevent suicide in inpatient hospital and emergency department settings.

Engage | Web

The Department of Veteran's Affairs developed a Mental Health Guide that offers recommended products and solutions to ensure individuals in inpatient care have a safe and therapeutically-enriching environment.

Transition | Web
Abstract: Providing follow-up calls to patients after they leave the hospital is not only good clinical practice, but it can help with the bottom line. In this study, the authors estimated the return on investment (ROI) for every $1 spent calling patients with suicidal ideation or deliberate self-harm who had been discharged from a hospital or emergency department. The ROI for the calls ranged from $1.76 to $2.43—a significant return that the authors concluded “supports the business case for payers, particularly Medicaid, to invest in postdischarge follow-up calls."


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SPRC and the National Action Alliance for Suicide Prevention are able to make this web site available thanks to support from Universal Health Services (UHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS) (grant 1 U79 SM0559945).

No official endorsement by SAMHSA, DHHS, or UHS for the information on this web site is intended or should be inferred.