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 ZEST?
The Texas Department of State Health Services (DSHS) has undertaken the aspirational goal of perfect patient safety for individuals receiving care through its public mental health system. DSHS, with support from a grant from the Substance Abuse and Mental Health Services Administration, is partnering with community mental health centers to develop suicide safe care in communities through the adoption of best practices.
The goals of the Zero Suicide in Texas (ZEST) initiative are 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.
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