Zero Suicide Framework

2023 Utah Zero Suicide Summit

What is Zero Suicide?

The basic belief of Zero Suicide is that suicide deaths for persons under care within health and behavioral health systems are preventable. It presents both a bold goal and a hopeful 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 basic responsibility of health care
To the safety and support of clinical staff, who do the demanding work of treating and supporting people with suicidal thoughts

The programmatic approach of Zero Suicide is based on the understanding that people with suicidal thoughts often fall through the cracks in a sometimes disconnected and distracted health care system. An orderly approach to quality improvement in these settings is both available and necessary.

The challenge and use of Zero Suicide cannot be done by practitioners providing clinical care alone. Zero Suicide needs a system-wide approach to improve results and close gaps.

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

Lead—Create a leadership-driven, safety-oriented culture committed to 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—Make sure every individual has a pathway to care that is both timely and acceptable to meet their needs. Include joint 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 results and better care for those at risk.

Putting the Zero Suicide Framework into use is a challenging system-wide responsibility. Technical support is available at no cost by emailing email Alyssa Mitchell. 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.
Do the Organizational Self-Study opens in a new tab
Complete the Zero Suicide Workforce Survey opens in a new tab to measure clinician skill and confidence in suicide intervention
Create a Zero Suicide Work Plan for using pieces of Zero Suicide in the policy and structure of your entity, based on the results of the Organizational Self-Assessment and Workforce Survey. Key components may include:
1. Suicide screening policy including when and how screening should be administered
2. Suicide in-depth assessment for those who screen positive for suicide risk
3. Suicide specific treatment and/or referral process
4. Follow up to manage ongoing risk
Participate in the Utah Zero Suicide Collaborative and Annual Summit
Continuously monitor and revisit the Organizational Self-Study, Workforce Survey, and Work Plan yearly to record progress and continue to work for excellence.

Technical support is available at no cost by emailing Alyssa Mitchell at aamitchell@utah.gov. You can request one-on-one technical assistance, staff training in pieces 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 using Zero Suicide in Utah.

Staff Training is an important part of Zero Suicide, and Utah law states mental health providers receive two hours of suicide prevention training per licensure period. Training should be part of organizational policy, be offered on a regular basis, and be specific to the level of care that staff is expected to provide (e.g. more specialized and in-depth training for clinical vs front desk staff). SUMH has collected the following lists of recommended trainings based upon job description:

Zero Suicide Recommended Training opens in a new tab

If you have any questions about these or would like to request in-person training, please contact email Alyssa Mitchell.

*Please note that this is not a list of all available training and that Utah SUMH does not recommend 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 email Alyssa Mitchell to participate.

Leading Zero Suicide efforts

Identifying risk

Engaging patients at risk

Transitions in care

Evaluating and improving efforts

If you have additional questions, contact Alyssa Mitchell by emailing aamitchell@utah.gov.

Resources

2024 Utah Learning Collaborative

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