During the 2010-2011 Action Alliance task force that created the Suicide Care in Systems Framework document, SAMHSA Suicide Prevention Branch Chief Richard McKeon said, “Over the decades individual clinicians have made heroic efforts to save lives, but systems of care have done very little.”
Zero Suicide IS the belief that a systems approach to robust quality improvement will yield a reduction in deaths among those served by healthcare systems, just like we have seen with every other complex major medical problem. It’s both a bold goal and aspirational challenge, while also a belief that suicide deaths for individuals under care within health and behavioral health systems are, in fact, preventable.
The Zero Suicide mentality is a demonstration of our commitment as healthcare leaders to patient safety, a focus on equipping and supporting our workforce to effectively engage and support those at risk, and an attempt to honor the thousands who have died.
Zero Suicide is an emerging toolkit of best practice approaches and a learning community of early adopter organizations.
Here’s what Zero Suicide IS NOT:
- A zero tolerance approach
- An effort to increase the already significant burden felt by many clinical professionals related to suicide
A 2015 Lancet article argued that Zero Suicide might contribute to “dysregulated responses” by healthcare systems that “might impair more adaptive responses such as containment of distress, safety planning, and negotiated responsibility with patients and carers.”
Actually, Zero Suicide argues that many healthcare organizations are already characterized in this fashion, and that a prioritized approach and support will yield both increased confidence and better results. In 2010, “The Forgotten Patient” (Forbes) detailed the reality of healthcare in the United States where “Fear, logistics, low research funding and more risk than reward… all conspire to make suicide the neglected disease.”
We surveyed more than 30,000 in the behavioral healthcare workforce across nine US states between 2009 and 2015. Less than half self-reported they had the combination of supports, skills and training to effectively engage those at risk of suicide.
In sum, Zero Suicide IS an attempt to replicate the success of many other initiatives taken to solve complex problems and reduce poor health outcomes and mortality. According to the architect of Crossing the Quality Chasm and interim DHHS Secretary Don Berwick, the effort is akin to what hospital systems have learned and implemented over the last 30 years to reduce infections (once thought intractable in hospital settings).