"Zero suicide" - a model for reducing suicide in United States behavioral healthcare
Open accessAbstract
Suicide is a serious public health concern in the US, especiallyfor those served in outpatient behavioral health. Over the pastdecade, there has been a dramatic increase in US suicide rates,and a significant proportion of those dying by or attemptingsuicide were treated in outpatient behavioral healthcare withinthe prior year. In response, the US Action Alliance released theNational Strategy for Suicide Prevention in 2012, a key tenet ofwhich is the «Zero Suicide» (ZS) model. ZS provides resourcesfor administrators and providers to create a systematic approachto quality improvement for suicide prevention in healthcaresystems via seven essential elements (Lead, Train, Identify,Engage, Treat, Transition, Improve). In this paper, we describethe ZS model, as well as our operationalization of the model inan NIMH-funded study in ~170 free-standing New York Stateoutpatient behavioral health clinics, serving >80 000 patients.This study is the largest implementation and evaluation of theZS approach ever conducted in outpatient behavioral health.Evaluation of ZS implementation in «real-world» clinical settingswill provide crucial insight regarding broader dissemination andinform how to best adopt empirically-supported care for suicidalpatients in outpatient behavioral health, thereby reducing tragicand preventable loss of life.Selvmord er et alvorlig folkehelseproblem i USA, spesielt for desom mottar poliklinisk behandling i psykisk helsevern. Det harvært en dramatisk økning i amerikanske selvmordsrater det sistetiåret, og en signifikant andel av de som forsøker å ta eller tar sitteget liv mottok poliklinisk behandling i psykisk helsevern innenfordet samme året. Som mottiltak publiserte The US Action Allianceen nasjonal strategi for selvmordsforebygging i 2012 med etgrunnprinsipp om nullvisjon, eller Zero Suicide på engelsk (ZS).Nullvisjonsmodellen tilbyr hjelpemidler for helsearbeidere for åskape en systematisk tilnærming til kvalitetsfor bedring i selvmordsforebyggingi helsevesenets systemer gjennom syv essensielleelementer (lede, lære opp, identifisere, engasjere, behandle, følgeopp, forbedre). I denne artikkelen vil vi beskrive nullvisjonsmodellen,samt vår implementering av modellen i en studie finansiertav NIMH (Nasjonalt institutt for psykisk helse i USA) i omtrent 170frittstående institusjoner for psykisk helsevern i delstaten New York,som til sammen omfattet over 80 000 pasienter. Denne studiener den største implementeringen og evalueringen av nullvisjonstilnærmingensom noensinne er blitt gjennomført i psykiatriskepoliklinikker. Å evaluere en slik nullvisjonsstrategi i kliniske settingerkan gi viktig kunnskap til bruk i bredere implementering og gimer kunnskap om hvordan innføre kunnskapsbasert polikliniskbehandling for suicidale pasienter i psykisk helsevern, og slikredusere forekomsten av tragiske dødsfall.
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A major component of the Zero Suicide model is generating system-wide cultural change that renders suicide prevention a core organizational goal of any medical setting.
“Specifically, a major component in the Zero Suicide model is generating system wide cultural change that renders suicide prevention a core organizational goal of any medical setting (Labouliere et al., 2018).”
From The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention (2021) · cites this paper as Labouliere et al., 2018
Zero Suicide approaches promote changes in the social environment within healthcare organizations to improve medicine's ability to prevent suicide.
“Additionally, suicide prevention strategies in healthcare – specifically so-called “Zero Suicide” approaches – promote changes in the social environment within healthcare organizations to improve medicine’s ability to prevent suicide (Labouliere et al., 2018).”
From The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention (2021) · cites this paper as Labouliere et al., 2018
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- Authors
- Labouliere, C. D., Vasan, P., Kramer, A., Brown, G., Green, K., Kammer, J., Finnerty, M., & Stanley, B.
- Affiliations
- Columbia University (US)
- New York State Office of Mental Health (US)
- University of Pennsylvania (US)
- Venue
- Suicidologi
- Publisher
- University of Oslo Library
- Published
- 2018-05-02
- Volume
- 23
- Issue
- 1
- Pages
- 22-30
- ISSN
- 0808-2227 (ISSN-L)
- 1501-6994
- PMC
- PMC6022755
- OpenAlex
- W2799721792
- Cited by
- 118
- References
- 25
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 19 · 2023: 17 · 2022: 10 · 2021: 23 · 2020: 15 · 2019: 11
- FWCI
- 14.39
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Suicidologi/Nytt i suicidologi (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (L30 MH114339, R01MH112139)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- suicide prevention, suicide attempters, suicide risk assessment, suicide intervention, suicide prevention training, implementation evaluation, psychiatric clinic
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