By Katie Baker

Last week I had the pleasure of attending and presenting at the Statewide Suicide Prevention Conference in Bloomington, Illinois. It was invigorating to be surrounded by professionals dedicated to a critical topic, and I wanted to share some of what I learned.

Some in the mental health field hold the belief that suicide is an inevitability for certain individuals with chronic suicidal tendencies; i.e., only so much can be accomplished interventionally for those determined to kill themselves.   But keynote speaker Dr. Mike Hogan of the National Action Alliance for Suicide Prevention thinks otherwise.

In his presentation, Dr. Hogan introduced the concept of “Zero Suicide.” Zero Suicide was born out of the patient-safety movement and is a commitment to suicide prevention in health and behavioral health care systems that uses a specific set of strategies and tools. Perhaps not surprising for a healthcare system that experiences 200,000 preventable deaths annually due to medical error, a staggering half of suicides occur in individuals who see a primary care doctor 30 days prior to their death. (For older males, 70 percent of those who die by suicide saw a primary care doctor in the preceding month!) In addition 30 percent of those who lose their lives to suicide see a mental health professional prior to their death. What this tells us is that people under care—including mental healthcare—are dying. Our “go to” systems for those at risk for suicide need to do more (and have needed to do more for some time).

Why? Healthcare professionals are still afraid to ask patients if they are thinking about suicide. In fact, very few primary care doctors routinely ask their patients about suicide. Additionally, most individuals who receive behavioral health services are assessed for suicide only at intake and the potential for suicide is not addressed again unless warranted by presenting symptoms. Individuals who are identified as “at risk” may be admitted temporarily to a hospital where depression symptoms may be addressed—but often the circumstances that cause the individual to be suicidal are never addressed.

Applied tools within the Zero Suicide approach include collaborative safety planning and restriction of lethal means; effective, evidence-based treatments that don’t just treat depression but directly target suicidal thoughts and behaviors; and more continuous patient contact and support, particularly after hospitalization for a suicide attempt.

Our current behavioral health system best practices allow for one follow-up appointment for those released from the hospital after a prior suicide attempt, with that appointment taking place within seven days of release. But the most critical time for another suicide attempt is the first few days after hospitalization discharge—and due to a lack of resources, often patients aren’t seen in the seven-day timeframe. More frequent and continuous contact with the patient, even in written form via e-mail and text, has been shown to reduce attempts.

We need systemic healthcare change as it relates to preventing suicide. We needed it yesterday.

To learn more about this movement go to