What is Zero Suicide?

Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems, and also a specific set of tools and strategies. It is both a concept and a practice. Its core propositions are that suicide deaths for people under care are preventable, and that the bold goal of zero suicides among persons receiving care is an aspirational challenge that health systems should accept.

-National Action Alliance for Suicide Prevention

What is the Suicide Care Initiative?

The Suicide Care Initiative (SCI) is a follow-up to the Zero Suicide in Texas (ZEST) initiative. ZEST was initiated by the Texas Department of State Health Services (DSHS) with the aspirational goal of perfect patient safety for individuals receiving care through its public mental health system. Following the successful completion of a grant from the Substance Abuse and Mental Health Services Administration, the Health and Human Services Commission (HHSC) continued to advance this goal by partnering with four Regional Suicide Care Support Centers (RSCSCs),  serving as regional centers of excellence in suicide safe care practices.

The goals of the Suicide Care Initiative are to:

1. Enhance suicide safer care at each of the RSCSCs through the establishment of the Zero Suicide framework and its practices throughout their entire agency. Each RSCSC will work to become a model program for Zero Suicide implementation in the state. 
2. Serve as training and technical assistance hub for community mental health centers throughout their region, providing evidence-based/best practice suicide specific Instructor trainings and coordinating a regional Learning Collaborative focused on implementation of Zero Suicide framework. The RSCSCs will serve as regional champions for safer suicide care, providing guidance on implementation practices and practical strategies for continuously monitoring and adjusting the approach. 

 The Texas Institute for Excellence in Mental Health (TIEMH) at the University of Texas at Austin supports the evaluation of the Suicide Care Initiative. The initial funding period for SCI is August 2019 to August 2021. 

What is the Texas Approach to Zero Suicide?

The Texas public health goal is to improve identification, treatment and support services for high risk youth by creating Suicide Safe Care Centers within the public mental health system; expanding and coordinating these best practice suicide prevention activities with other youth serving organizations and community partners to create Suicide Safe Care Communities; and implementing research-informed training and communications efforts to create a Suicide Safe Care State.

Texas Suicide Safe Care Model

As identified by the National Action Alliance for Suicide Prevention, the core dimensions of zero suicide include:

• Creating a leadership-driven, safety-oriented culture that commits to dramatically reducing suicide among people under care and includes suicide attempt and loss survivors in leadership and planning roles
• Systematically identifying and assessing suicide risk levels among people at risk
• Ensuring every person has a pathway to care that is both timely and adequate to meet their needs
• Developing a competent, confident, and caring workforce
• Using effective, evidence-based care, including collaborative safety planning, restriction of lethal means, and effective treatment of suicidality
• Continuing contact and support, especially after acute care
• Applying a data-driven quality improvement approach to inform system changes that will lead to improved patient outcomes and better care for those at risk

Core elements of zero suicide approach