By Dr Laura Leone, DSW, MSSW, LMSW
Integrated Health Consultant for Practice Improvement, National Council for Behavioral Health

Suicide prevention can seem like a daunting undertaking for any health center, but as the number of deaths by suicide keep increasing, it becomes a necessary public health issue to be addressed within primary care. If your health center is overwhelmed with how to proceed, the following eight steps are a framework to give you the guidance on what to do.

  • Step 1: Identify Leadership, Champions and Task Force: It’s important to get many people involved in suicide-prevention efforts, supporting it both from the “bottom up” and from the “top-down.” It is most effective to find staff in several disciplines and roles that are not just from behavioral health, as well as to consider how to include the voice and choice of patients.


  • Step 2: Educate and Inspire Change: When people understand why change, new workflows or asking the hard questions is necessary, they are more likely to engage in doing it, and doing so well. Educate people on suicidality, including national and local statistics; on the various opportunities during work to ask people about suicide; and on ways to intervene when necessary.


  • Step 3: Gauge the Current Organizational Landscape: Understand the baseline metrics around suicide for your organization, such as when people are most “at risk,” how many deaths by suicide, how many suicide attempts, how many safety-planning interventions are used with patient expressing suicidality, etc.


  • Step 4: Practice Improvement: Take education a step further with understanding best practices around suicide inquiry, screening and evidence-based interventions. There are opportunities to assist clients in their outpatient setting rather than them visiting a hospital emergency department.


  • Step 5: Imbed Throughout Organization: Consider how to optimize your electronic health record around suicide-prevention efforts, including the use of decision supports, problem lists, and other features. Effectively communicating around patients who are “at risk” in real time could save a life. Likewise, find multiple ways to discuss suicide prevention efforts with staff, such as at staff meetings and during huddles; creating a continual feedback loop using the data collected.


  • Step 6: Ongoing Mining of Resources and Supports: There are constantly new resources, trainings and support around suicide prevention for both patients and staff. Take the time to periodically check in on what’s new, from organizations such as the National Council for Behavioral Health, Suicide Prevention Resource Center, Zero Suicide, Now Matters Now and more.


  • Step 7: Collaborate with Patients, Community, External Organizations, and Stakeholders: Consider how to best share information and support patients in the community around their suicidality, and to help create opportunities for wellness. Efforts and success will be greater and stronger when people and organizations collaborate, as well as share information and resources.


  • Step 8: Wash, Rinse, then Repeat! Don’t get comfortable in going through these steps once. Instead, run through them again and again to keep your continual quality improvement going for suicide prevention. Continue to use your metrics to gauge improvement opportunities and successes.

Remember that the Health Center Association of Nebraska and the National Council for Behavioral Health are available to provide support around building internal and external capacity for suicide prevention. You can make a difference by preventing deaths by suicides and the negative impact that every death has on the surviving 135+ lives that the person leaves behind.