Two leadership drives are the keys to the dramatic reductions in suicide deaths achieved by Zero Suicide organisations. The first is leadership mobilising staff to believe that suicide can be prevented. The second is an unwavering focus maintaining that zero suicides is the goal. Leadership must both convince staff to see and believe that suicide can be prevented and provide tangible supports in a safe and blame-free environment—what is known as a just culture.
In a Zero Suicide approach:
- The organisation has a policy specific to suicide care.
- The policy emphasises the importance of the core components of safer suicide care, covered in detail in the other six sections of this Zero Suicide Toolkit:
- TRAIN: Training a caring, confident, and competent workforce in up-to-date suicide safer care
- IDENTIFY: Identifying patients or clients with suicide risk via comprehensive screenings
- ENGAGE: Engaging all individuals at-risk of suicide in a suicide care management plan
- TREAT: Treating individuals with suicidal thoughts and behaviour via evidence-based treatments
- TRANSITION: Transitioning individuals through care with warm hand-offs and supportive contacts
- IMPROVE: Improving policies and procedures through a continuous quality improvement plan
The organisation’s policy specifies a program for preventing compassion fatigue among all staff who interact with patients at risk of suicide.
Establish a Team
- A Zero Suicide implementation team is established with the charge, tasks, and roles of members clearly defined, including:A schedule for regular team meetings
- Authority for changing policies and procedures
- An evaluation plan designed to assess the impact of the initiative
- Responsibility for continuous quality improvement and the development of specific approaches to measuring and reporting on all suicide deaths
- The suicide bereaved and those with lived experience are part of the Implementation Team and participate in some or all of the following activities:Providing regular input and advice
- Assisting with workforce hiring and/or training
- Participation in evaluation and quality improvement efforts
- Participation in multiple aspects of suicide care
- The Implementation Team completes a Zero Suicide Organisational Self-Study and uses the results to set organisational goals.
- A budget supports Zero Suicide implementation.
- The Implementation Team explores ways to link Zero Suicide to other initiatives, such as trauma-informed care or substance abuse prevention and treatment programs.
- The Team reviews all of the organisation’s policies to determine what new policies need to be developed. Policies and procedures include:Approaches to measuring and reporting on all suicide deaths
- Supports provided to staff that have experienced suicide death of a client
- Suicide care planning is embedded in the electronic health record
- The staff is trained on the use of the electronic health record to track clients at risk for suicide.
For more information about the Self-Study and to view the tool, go to the Organisation Self-Study at the bottom of this page. For more discussion on involving suicide attempt survivors. Each section of the Zero Suicide Toolkit describes a core component of the approach, including specific features that organisational policies should contain.
- The CEO or another member of senior management conducts a presentation about the Zero Suicide philosophy, approach, and key elements to the board of directors on Zero Suicide
- The CEO and Implementation Team communicate the Zero Suicide philosophy, rationale, approach, and merits of this initiative to staff and establish a process for regular updates, at least annually
- Changes as a result of the Zero Suicide initiative, including patient outcomes, are communicated to staff
- The implementation team provides management with training on the Zero Suicide philosophy, essential elements, and implementation plan
- The CEO and implementation team state a commitment to transparency and a no-blame culture when adverse events do occur
Zero Suicide Organisational Self-Study
The Organisation Self Study form has been developed and tested by the Suicide Prevention Resource Centre in the US. They have made this available for organisations looking to apply a Zero Suicide mindset to their practice and can be downloaded here.