Resources

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

Displaying 1 - 14 of 14
Train | Web

The presence of a competent, confident, and well-trained workforce at every level of care is critical to individuals at risk of suicide. Data from more than 15,000 health and behavioral health care staff who utilized an online Zero Suicide Workforce Survey indicates that, among those interact with patients or clients, only half had received training in suicide screening or risk assessment and only about a third felt strongly that they had the appropriate knowledge, skill, confidence, and comfort in providing care for individuals at risk of suicide.

It is clear that opportunities remain for improving workforce readiness and ensuring that staff are adequately trained to care for individuals at risk for suicide. While assessing workforce readiness is critical, organizational leadership must also acknowledge and take responsibility for training deficits and prepare staff to deliver evidence-based suicide care. The Zero Suicide Workforce Survey is a free online tool that organizations can use to assess staff knowledge and comfort in working with individuals at risk for suicide.

In this webinar, you will hear from leaders of three health care organizations who used the results of the Zero Suicide Workforce Survey to establish a culture where staff training is a critical and ongoing part of providing quality care. By the end of this webinar, participants will be able to: (1) describe how surveying staff can support system-wide culture change critical to patient safety and continuous quality improvement, (2) understand staff readiness to provide suicide-specific care, and (3) explain the purpose and utility of the Zero Suicide Workforce Survey to health care staff. 

Lethal Means Reduction | Web

SAMHSA’s Center for the Application of Prevention Technologies (CAPT) and the Suicide Prevention Resource Center (SPRC) hosted a national webinar series that explores the intersection of opioid misuse, overdose, and suicide—with an in-depth look at chronic pain as a contributing factor to these related problems.  These webinars examined the national narrative on opioids and suicide, drawing on current research to define the scope of the problem and explore how these health concerns intersect. The purpose of this series was to illustrate the connections between suicide and opioid misuse—so that substance misuse and suicide prevention practitioners can develop a coordinated response to them. The series highlights opportunities for alignment and feature examples of partnerships between the suicide and substance misuse prevention fields.

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.

The PDF available below includes the webinar slides and transcript. 

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 webmaster@sprc.org

Transition | PDF, Web

In a Zero Suicide approach, safe suicide care in health and behavioral health organizations involves establishing guidelines and protocols that create smooth and uninterrupted care transitions across and within care settings. It is equally important to address suicide risk at every visit within an organization, from one behavioral health clinician to another or between primary care and behavioral health staff in integrated care settings. Some examples of innovative approaches to providing safe care transitions include establishing practices that remove barriers to scheduling follow-up appointments, creating agreements between acute care settings and outpatient providers to deliver care to discharged patients within 24 hours, using supportive contacts, involving peer support, and utilizing crisis services to provide care coordination and follow-up. During this webinar, presenters will help participants think of ways they can improve safe care transitions through their organizational policies using a variety of tools and resources.

By the end of this webinar, participants will be able to (1) Identify key care transition practices and partnerships for patients discharged from inpatient to outpatient care, (2) describe how one organization includes voices of individuals with lived experience in care transition practices, and (3) demonstrate how health and behavioral health organizations can establish partnerships with crisis service organizations to augment care transition practices.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Improve | PDF, Web

In a Zero Suicide approach, a data-driven quality improvement approach involves assessing two main categories: fidelity to the essential systems, policy, and patient-care components of the Zero Suicide model, and patient-care outcomes that should come about when the organization implements those essential components. Zero Suicide implementation teams should identify key clinical care outcomes that indicate systems-level and clinical practice changes are having an impact, and establish systems to collect these data regularly to monitor areas for change and continuous improvement. Reviewing the existing quality improvement measures in the behavioral health field may be informative for establishing systematic data collection in your organization. In addition to quantitative data, organizations can also consider collecting qualitative data that assesses individuals’ experience and satisfaction receiving care. 

By the end of this webinar, participants will be able to (1) understand how data collection can be used to enhance the care that health and behavioral health care organizations provide to individuals at risk of suicide, (2) describe the current status of quality improvement measures in the suicide prevention field, and (3) describe how one organization used data to improve suicide risk assessment practices.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Lead | PDF, Web

A patient's death by suicide in health and behavioral healthcare organizations can have a significant impact on family members, other patients, and staff. It may be even more destabilizing or demoralizing in systems where significant changes to improve suicide care had been implemented. Optimal postvention practices in health and behavioral healthcare organizations highlight immediately supporting the family, other clients and staff, conducting root cause analyses, and embedding policies and protocols supporting postvention actions into the organization's operations. Consistent with a Zero Suicide framework, leadership should ensure that policies and practices promote an organizational response that is consistent with a just, no-blame culture that remains focused on continuous quality improvement in the aftermath of a patient suicide.

This webinar will focus on how health and behavioral healthcare organizations respond following a patient suicide death. Participants will hear from health care leaders and experts who will discuss key components of an organization-level postvention plan. They will explore considerations for supporting patients, staff and the community, and continuing to provide quality care. Additionally, a clinician survivor will share her perspective on what she felt was supportive after experiencing a patient suicide.

By the end of this webinar, participants will be able to (1) Explain how a health and behavioral health organization’s response to a suicide death can support improvements in suicide care practices; (2) Describe the role of Root Cause Analysis in a postvention response; and (3 )Identify steps that can be taken by organizations to support staff, other patients, and the family following a patient's death by suicide.

Transcripts available on request. Please direct requests to webmaster@sprc.org.

Lead | PDF, Web

Health and behavioral health care (HBH) organizations and providers implementing suicide prevention practices often have concerns about liability and legal issues. Providing quality patient care while minimizing liability risk is a priority across HBH organizations, especially when caring for patients at risk for suicide. Liability risks can be reduced when providers deliver patient-centered care with embedded systems-level communication and documentation practices.

Health and behavioral health care organizations can support providers and manage risk by adopting practices that ensure that suicide risk is properly identified and assessed, timely and effective treatment that allows for patient choice and involvement is provided, patient health information is appropriately communicated between providers, patients and collaterals, and documentation is thorough.

This webinar will explore the legal and liability issues related to implementing systems-level changes designed to improve suicide care practices. Participants will hear from three experts who will discuss common liability concerns including those related to confidentiality and HIPAA, key elements considered in liability cases, and strategies to minimize liability against a provider or health care organization.

By the end of this webinar, participants will be able to (1) Identify misconceptions related to provider liability in litigation involving patient suicide; (2) Describe suicide care practices that are of particular importance in liability cases; and (3) Explain system- or organizational-level improvements to suicide care that can enhance an organization’s abilities to deliver quality care and minimize liability concerns. 

Transcripts available on request. Please direct requests to webmaster@sprc.org

Lead | PDF, Web

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.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Lead | PDF, Web

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.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Treat | PDF, Web

While talented, dedicated clinicians have made heroic efforts to work with suicidal clients, most behavioral health clinicians have never received any formal training in suicide care and treatment.  Individuals at risk for suicide who seek help from a behavioral health professional should expect to receive care that is research-informed, collaborative, and that focuses explicitly on suicide risk. Research suggests that practitioners who have received formal training in suicide care models have improved confidence, competence, and efficacy. In a comprehensive Zero Suicide approach, a skilled and savvy workforce that has extensive training in suicide care and treatment is critical. This webinar will focus on why using evidence-based care that focuses on treating suicide directly is essential and will discuss two highly researched models of treatment: Collaborative Assessment and Management of Suicidality (CAMS) and Dialectical Behavior Therapy (DBT). Frequently encountered obstacles in delivering evidence-based care will also be explored. Finally, an individual with lived experience will describe the improved outcomes she experienced as a result of working with a well-trained clinician.

By the end of this webinar, participants will be able to (1) explain how using evidence-based approaches to treatment improves outcomes for those at risk for suicide; (2) recognize the importance of treating suicide symptoms directly; (3) describe two evidence-based models of suicide care; and (4) understand the perspective of people with lived experience and how it is impacted by receiving evidence-based care.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Engage | PDF, Web

Safety planning and means reduction are integral parts of comprehensive suicide care. Clinicians should collaboratively develop safety plans with all persons identified as at risk for suicide, immediately after identifying the risk. The plan should include steps to restrict access to lethal means, balanced with respect for legal and ethical requirements under federal and state laws. In order to develop effective safety plans and organizational policies for lethal means assessment and counseling, training for staff is typically necessary and the input of those with lived experience is essential.

By the end of this webinar, participants will be able to (1) identify safety planning and lethal means reduction as part of a comprehensive Zero Suicide approach; (2) discuss ways to maximize the effectiveness of a safety plan; (3) develop an organizational policy for lethal means reduction; and (4) explain the importance of input from people with lived experience during safety planning and means reduction policy development.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Identify | PDF, Web

Screening for suicide risk is a recommended practice for primary care, hospital and emergency department care, behavioral health care, and crisis response intervention. Any person who screens positive for possible suicide risk should be formally assessed for suicidal ideation, plans, means availability, presence of acute risk factors, history of suicide attempts, as well as for the presence of protective factors.  This information should be synthesized by an appropriately trained clinician into a risk formulation that describes the person’s risk as well as serves as the basis for treatment and safety planning. While screening and assessment should be standardized, every client is unique. It is incumbent on the clinician to use the screening and assessment process to establish a collaborative relationship with the client and to ensure his or her safety and well-being.

This webinar will focus on screening and assessment for suicide in health care settings using a patient-centered approach.  The objectives for this webinar are to: (1) understand why screening is part of a comprehensive approach to suicide care; (2) determine how to select a suicide screener; (3) recognize the difference between screening and assessment; (4) identify the problems with categorizing risk into levels (low, medium, high) and gain exposure to an alternative approach for formulating and communicating about risk in a health system; and (5) identify a patient-centered approach to screening and assessment.

Transcripts available on request. Please direct requests to webmaster@sprc.org

Lead | PDF, Web

The programmatic approach of Zero Suicide is based on the realization that suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted health care system, and on the premise that a systematic approach to quality improvement is necessary. Essential dimensions of suicide prevention for health care systems (health care plans or care organizations serving a defined population of consumers such as behavioral health programs, integrated delivery systems, and comprehensive primary care programs) have been identified as necessary for a comprehensive approach.

By the end of this webinar, participants will be able to (1) describe the seven dimensions of Zero Suicide and how they differ from the status quo of suicide care and (2) discuss the tools and recommended next steps for health care organizations seeking to adopt a Zero Suicide approach.

Transcripts available on request. Please direct requests to webmaster@sprc.org

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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.