September 25, 2017

From Meghan Crane, Zero Suicide Program Coordinator, Public Health Division, Oregon Health Authority

A Role in Preventing Suicide

During National Suicide Prevention Month in September, messages relay that we all have a role in preventing suicide. This message extends to healthcare organizations—including behavioral health, hospital systems, primary care, emergency departments, and healthcare coverage—to transform suicide care to significantly reduce suicide. There has been a recent focus on healthcare’s role in preventing suicide, particularly in emergency department and primary care settings. This focus is due to the mounting evidence showing that most people who die by suicide come into contact with a healthcare system in the year leading up to their death. Often this is not in a behavioral health setting. Research also shows that an ACE score of 7 or more increased the likelihood of childhood or adolescent suicide attempts 51-fold and adult suicide attempts 30-fold. This identifies a need to recognize people at risk of suicide and refer them to appropriate care, while utilizing trauma informed approaches and treatment.

Zero Suicide Approach

There is a growing movement called the Zero Suicide Initiative. The Zero Suicide approach aims to improve care and outcomes for individuals at risk of suicide in healthcare systems by focusing on the assessment and management of suicide which is often not addressed directly. 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 and aligns with SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach in many ways. For example, Zero Suicide emphasizes safety of the client while also recognizing the vital role safety and support of clinical staff plays in their ability to assist patients with thoughts of suicide or a history of suicide attempts. Similar to SAMHSA’s Trauma-Informed Approach principle of Peer Support, Zero Suicide recognizes the vital role that people with lived experience (both of suicide loss and of suicide thoughts/attempts) bring to preventing suicides. The Zero Suicide Initiative promotes incorporation of people with lived experience in developing, implementing, and evaluating efforts. The principle of Collaboration and Mutuality is emphasized in Zero Suicide as well. Suicide safer care requires input and collaboration with the patient. A safety plan to help a client when they experience a suicidal crisis will not be successful without empowering the patient to provide what activities and who will help them while in crisis. These are just a few examples of how Zero Suicide and trauma-informed work can align.

Organizational Assessment

The Oregon Health Authority (OHA) is working with healthcare and communities around the state to implement the Zero Suicide Initiative. A great first step to see how your organization may already be practicing Zero Suicide and identify what areas you have work to do is by taking the Zero Suicide Organizational Self- Assessment. Please email me about your suicide prevention and suicide safer care initiatives! meghan.crane@state.or.us Together, we can significantly reduce the impact that suicide has in Oregon!