The goal of this paper is to highlight key steps emergency department (ED) providers can take to establish continuity of care for patients at risk for suicide, and thereby, to substantially reduce the number of suicide deaths and suicide attempts that occur after discharge. The risk of suicide attempts and death is highest within the first 30 days after a person is discharged from an ED or inpatient psychiatric unit, yet as many as 70 percent of suicide attempt patients of all ages never attend their first outpatient appointment. Therefore, access to clinical interventions and continuity of care after discharge is critical for preventing suicide.
A multi-source collection of readings, tools, videos, and webinars to help you understand and implement Zero Suicide.
Beckstead, D. J., Lambert, M. J., DuBose, A. P., & Linehan, M. (2015). Dialectical behavior therapy with American Indian/Alaska Native adolescents diagnosed with substance use disorders: Combining an evidence based treatment with cultural, traditional, and spiritual beliefs. Addictive behaviors,51, 84-87.
Bigfoot, D. S., & Schmidt, S. R. (2010). Honoring children, mending the circle: cultural adaptation of trauma‐focused cognitive‐behavioral therapy for American Indian and Alaska Native children. Journal of clinical psychology,66(8), 847-856.
Nebelkopf, E., & King, J. (2003). A holistic system of care for Native Americans in an urban environment. Journal of Psychoactive Drugs, 35(1), 43-52.
In 2014, six states and their provider partners set out with the Suicide Prevention Resource Center and the National Council for Behavioral Health on the Zero Suicide Breakthrough Series—a project designed to learn how best to support the successful launch and implementation of the Zero Suicide approach under the direction of a state mental health or public health office. State leaders who had already begun the process of launching Zero Suicide initiatives were asked to invite a provider organization to partner with them in the process. Over the course of the nine-month Breakthrough Series period, they were given additional technical assistance and supports to move towards suicide safer care practices. This report details lessons learned throughout the process.
Pisani, A. R., Murrie, D. C., & Silverman, M. M. (2015). Reformulating Suicide Risk Formulation: From Prediction to Prevention. Academic Psychiatry, 1–7.
David Jobes, PhD, ABPP, Professor of Psychology, Associate Director of Clinical Training, The Catholic University of America, discusses a "Stepped Care" model for suicide prevention.
The National Action Alliance for Suicide Prevention released the comprehensive Suicide Prevention and the Clinical Workforce: Guidelines for Training to assure that the U.S. clinical workforce is adequately prepared to treat persons at risk for suicide. The Action Alliance’s Clinical Workforce Preparedness Task Force spent over three years developing the guidelines to serve as the foundation for creating suicide prevention training programs in health and human services professions, such as nursing, social work, medicine, school counseling, and the full range of behavioral health and primary care disciplines. This initiative was designed so that each discipline could use the guidelines to develop specific continuing education curricula and train new clinicians to deliver optimal suicide care.
In a trauma-informed approach, a behavioral health organization understands and develops a framework to best serve clients with histories of trauma. The system, and all employees in the system, understands the role that trauma can play in each person’s care and recovery. With trauma-informed care, the organization develops safeguards to ensure that the setting in which services are delivered, and the particular services offered are competent, safe, evidence-based, patient-centered, and do not re-traumatize individuals with histories of trauma. The input of those with lived trauma experience is essential in the development, delivery, and evaluation of services. The Zero Suicide approach frames care for those at risk for suicide in much the same way that trauma-informed care provides a framework for serving those with histories of trauma. Many of the principles are similar: provide timely, effective, competent, evidence-based services that consider the individual’s history and relies on the input of those with lived experience to improve the agency’s care. Given the similarities between these two frameworks and the overlap in clients presenting with both trauma and suicide, several organizations have begun to pair Zero Suicide with their trauma-informed care initiatives. During this webinar, we will explore the relationship between trauma-informed care and Zero Suicide, and hear about two organizations that have designed training and policies using both frameworks.
By the end of this webinar, participants will be able to (1) Explain the prevalence and impact of traumatic stress and its relation to suicide; (2) Describe the similarities of Zero Suicide and trauma-informed care; and (3) Discuss ways to embed a Zero Suicide approach in an organization that has already adopted a trauma-Informed care culture.
The availability of support groups specific to attempt survivors, peer-operated warm lines, and the presence of peer navigators can greatly enhance traditional care for those at risk of suicide. During this webinar you will hear from presenters who have used unique approaches, incorporating the voice of lived experience, to guide treatment and prevention efforts to better support those in clinical settings at risk for suicide.
By the end of this webinar, participants will be able to (1) Explain the important role of embedding peer supports and those with lived experience in a comprehensive Zero Suicide model; (2) Discuss how to engage, hire, and collaborate with peer support professionals; (3) Recognize the importance of using programs designed specifically to support attempt survivors; and (4) Describe crisis or emergency services who offer peer support services.
Linda Rosenberg, President & CEO of the National Council for Behavioral Healthcare, discusses the role of advocacy and education in Zero Suicide.
Mike Hogan, Co-Lead of the Zero Suicide Advsory Group and former Commissioner of the New York State Office of Mental Health, explains how suicide in health care should be thought of as a never event.
Ed Coffey, CEO of Behavioral Health Services at Henry Ford Health System, discusses the origins Zero Suicide in Perfect Depression Care.
This worksheet is intended to assist health and behavioral health care organizations in developing a data-driven, quality improvement approach to suicide care. The worksheet (1) reflects the top areas of measurement that behavioral health care organizations should strive for to maintain fidelity to a comprehensive suicide care model; and (2) includes a list of supplemental measures that organizations may want to consider. The Data Elements Worksheet should be completed every three months, and an evaluation team should use the findings to determine areas for improvement.
Can Suicide Be a Never Event? is a short PowerPoint presentation with speaking points that Zero Suicide champions can customize to present to any audience—organization CEOs, board of directors, senior management, or staff.
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