A couple of months ago I briefly discussed the idea of consistent assessment of suicidal risk. It is one of the key areas of assessment we, as clinicians, have as a responsibility. 

Many clinicians do not receive much training in suicide risk management, and many clinicians are uncomfortable assessing for suicidality or addressing suicidality in treatment. I have had a keen interest in clinical management of suicidal risk for many years, and so have tried to stay abreast of some of the “best practice” approaches. One of the more intriguing programs I have found is Zero Suicide.

For those of you who have not heard of it, Zero Suicide is the result of a partnership between the National Action Alliance for Suicide Prevention, the Suicide Prevention Resource Center, and other experts in the field of suicide prevention. Arising out of a 2011 to 2013 task force, the Zero Suicide model identifies key framework for safe suicide care with the ultimate goal of effectively eliminating completed suicides for individuals in treatment.

That’s right – eliminate. Far from some sort of aspirational endeavor, the Zero Suicide model’s core value starts with the belief that suicide can be eliminated in a “population under care” through improving both the access to services and the quality of those services.

Zero Suicide takes a systemic approach across systems of care establishing a notion where suicides as an outcome is no longer acceptable and encourage evidence-based practices which show themselves to be effective. Fidelity to these frameworks is key to its effectiveness.

The elements to Zero Suicide include:
  • · Lead system-wide culture change committed to reducing suicides.
  • · Train a competent, confident, and caring workforce.
  • · Identify individuals with suicide risk via comprehensive screening and assessment.
  • · Engage all individuals at-risk of suicide using a suicide care management plan.
  • · Treat suicidal thoughts and behaviors directly using evidence-based treatments.
  • · Transition individuals through care with warm handoffs and supportive contacts.
  • · Improve policies and procedures through continuous quality improvement.
The Zero Suicide website, zerosuicide.edc.org, provides a wide variety of resources and training recommendations, along with outcome stories and data. 

With suicide being the second leading cause of death for children ages 10 through 14, and third among individuals aged 15 to 24 in the United States, and that nearly 5 percent of all adults in the U.S. experiencing suicidal thoughts every year, being effectively trained is a key skill to be an effective clinician working with these individuals.