Healthcare-Based Prevention Resources
Zero Suicide in Healthcare
- Overview
- Lead
- Train
- Identify
- Engage
- Treat
- Transition
- Improve
- Resources for Healthcare Staff
Zero Suicide in Healthcare is a way to improve suicide care within healthcare systems. The foundational belief of Zero Suicide is that suicide deaths for individuals under the care of medical providers are preventable; studies have shown the majority of people who died by suicide saw a healthcare provider in the year prior to their death. For healthcare systems dedicated to improving patient safety and stability, Zero Suicide offers an aspirational challenge and practical framework for system-wide transformation toward safer suicide care. Zero Suicide is based on the realization that people experiencing suicidal thoughts and urges often fall through the cracks in a sometimes fragmented health care system. There is an opportunity for health care systems to make a real difference by transforming the care patients receive.
Current Suicide Trends
In Oklahoma:
- Suicide is the 9th leading cause of death in Oklahoma.2
- In 2020, 869 Oklahomans died by suicide.2
- The age adjusted suicide rate in 2020 was 22.2 per 100,000 individuals, higher than the national rate.2
- On average, one person died by suicide every 11 hours in Oklahoma.2
- In 2020, firearms accounted for 61.9% of all suicide deaths.2
In the United States:
- Suicide is the 12th leading cause of death.1
- In 2020, 45,979 Americans died by suicide; an estimated 1.2M suicide attempts were made.1
- The age-adjusted suicide rate in 2020 was 13.48 per 100,000 individuals.1
- On average, there are 130 suicides per day.1
- In 2020, firearms accounted for 52.83% of all suicide deaths.1
93% of adults surveyed in the U.S. think suicide can be prevented.1
Zero Suicide Research
- The Relationship Between Suicidal Behaviors and Zero Suicide Organizational Best Practices in Outpatient Mental Health Clinics
- Efficacy of the Zero Suicide framework in reducing recurrent suicide attempts: cross-sectional and time-to-recurrent-event analyses
Zero Suicide Outcome Stories
- Zero Suicide Outcomes One-Pager
- Zero Suicide Case Studies
Zero Suicide Foundational Principles
- Core Values: the belief and commitment that suicide can be eliminated in a population under care by improving service access and quality and through practicing continuous quality improvement.
- Systems Management: taking systematic steps across systems of care to create a culture that no longer finds suicide acceptable, setting aggressive but achievable goals to eliminate suicide attempts and deaths, and organizing service delivery and support accordingly.
- Evidence-Based Clinical Care Practices: adopting practices that research shows reduce suicide deaths and behaviors and that are delivered through the entire system of care and that emphasize productive patient-staff interactions.
Lead system-wide culture change committed to reducing suicides
Train a competent, confident and caring workforce
- Zero Suicide Care Training Options
- Zero Suicide Training Workshops
- Zero Suicide in Primary Care (ODMHSAS)
Additional Training Resources
2021 Zero Suicide Summit: Zero Suicide in Primary Care
Suicide Prevention Resource Center (SPRC)
Research Articles
Identify individuals with suicide risk via comprehensive screening and assessment
Screening Tools
- PHQ-9: Patient Health Questionnaire
- C-SSRS: Columbia Suicide Severity Ratings Scale
- ASQ: Ask Suicide-Screening Questions
- PSS-3: Patient Safety Screener
- SAFE-T: Suicide Assessment Five-Step Evaluation and Triage
Additional Screening Resources
Engage all individuals at-risk of suicide using a suicide management plan
Pathways to Care
- ZS Pathway to Care
- Institute for Family Health Clinical Pathways for Managing Suicidality
- ZS Suicide Care Pathway Coding for Primary and Behavioral Health Care
- Care Pathways: Centerstone – Adding a Pathway to our Treatment Plan Fact Sheet
Unique Settings
- Caring for Adult Patients with Suicide Risk: A Consensus Guide for Emergency Departments
- Integrated Primary Care & Behavioral Health
- Substance Use Disorder Treatment
- Inpatient Mental Health
Safety Planning
- Stanley Brown Safety Plan
- Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk
Research Articles
- Development of a Clinical Guide to Enhance Care for Suicidal Patients
- Ethical and Competent Care of Suicidal Patients: Contemporary Challenges, New Developments, and Considerations for Clinical Practice
- Building a Therapeutic Alliance with the Suicidal Patient
Special Populations
Native Americans & Alaska Native
- ZS Keys for Sustainability for Health and Behavioral Health Care Programs in Indian Country
- Is Your Tribal or IHS-Led System Ready to Implement Zero Suicide?
- Is Your Tribal or HIS-Led System Not Quite Ready to Implement Zero Suicide?
- Getting Started with Zero Suicide for Tribal and HIS-Led Systems
Military & Veterans
- VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients At Risk for Suicide
- Treatment Works for Vets
- Suicide Risk Management Consultation Program
Children & Youth
- Adolescent Suicide Prevention and Medical Settings (Webinar)
- OKCAPMAP – Oklahoma Child and Adoloescent Psychiatry and Mental Health Access Program
LGBTQ
Treat suicidal thoughts and behaviors directly using evidence-based treatments
Treatment Resources
CALM: Counseling on Access to Lethal Means
Reducing access to lethal means, such as firearms and medication, can determine whether a person at risk for suicide lives or dies. This free online course focuses on how to reduce access to the methods people use to kill themselves. It covers how to: (1) identify people who could benefit from lethal means counseling, (2) ask about their access to lethal methods, and (3) work with them—and their families—to reduce access. While this course is primarily designed for mental health professionals, others who work with people at risk for suicide, like social service professionals and health care providers, may also benefit from taking it.
Patient Facing Resources
- NIMH My Mental Health: Do I Need Help?
- NIMH Tips for Talking with a Healthcare Provider about your Mental Health
- NIMH Stress Catcher: Catch Some Great Coping Strategies and Skills for Managing Stress
- NIMH Warning Signs of Suicide
- NIMH I’m So Stressed Out Fact Sheet
- NIMH Five Action Steps for Helping Someone in Emotional Pain
Transition individuals through care with warm hand-offs and supportive contacts
Best Practices
Referral Network for Patients
Provider Resources
Improve policies and procedures through continuous quality improvement
- RAND Suicide Prevention Program Evaluation Toolkit
- Zero Suicide Data Elements Worksheet
- Framework for Conducting a Root Cause Analysis and Action Plan
- Zero Suicide Breakthrough Series: Outcomes and Recommendations
Additional Suicide Prevention Resources
- American Hospital Association (AHA)
- American Psychiatric Association Practice Guidelines for the Assessment and Treatment of Patients with Suicidal Behaviors
- American Foundation for Suicide Prevention (AFSP)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Suicide Awareness Voices of Education (SAVE)
- Suicide Prevention Resource Center (SPRC)
- World Health Organization (WHO)
Healthcare Staff Self-Care Resources
- Oklahoma State Medical Association Physician Wellness Program
- A Guide to Promoting Healthcare Workforce Well-Being: During and After COVID-19 Pandemic
- Bolstering Resilience for Frontline Staff
- Telehealth Tips: Managing Suicidal Clients During the COVID-19 Pandemic
- Caring for Your Mental Health (NIMH)
- RPR Exchange: University of Oklahoma Health Sciences Center