Suicide is complex and it is well accepted that it requires multiple approaches. A recent editorial in Crisis explored the progress and challenges associated with national suicide prevention strategies and concluded that despite many countries efforts to produce national strategies their implementation falls short.(1)
One area of implementation that is gathering traction is in improved hospital care. We are seeing an increasing interest in, and an increasing number of countries testing, the Zero Suicide Healthcare model published by the US National Action Alliance for Suicide Prevention in 2012.(2)
Estimates in Australia suggest that one in five suicides is a person who has been in the care of the healthcare system. We know who they are. We know their treatment pathway. They should be leaving the system with a safety plan in place developed in collaboration with their clinicians and their family member or carer and linked into stronger community-based services. Those who enter our healthcare system have the right to a better experience, one which Zero Suicide Healthcare can deliver.
This week the Zero Suicide Healthcare International Declaration will be released. As a member of the international learning community for Zero Suicide Healthcare I am calling on our governments and healthcare leaders to commit their services to improved quality care. The Fifth Mental Health & Suicide Prevention Plan has within Priority Area 2 the statement that “Health services should aim for zero suicides within health care settings” (page 23)(3). The International Declaration provides the key drivers to support implementation:
Leadership centred on a just, safety-driven culture informed by evidence and lived expertise
A teamwork approach when engaging those who are suicidal
Active participation of patients, health professionals and family members or carers in safety planning and transition to aftercare
Data and implementation science deliver continuous improvement
Synergy in collaborative networks with general and public healthcare or community suicide prevention initiatives.
I know that no one strategy will achieve our desired state. Implementing a program within a health service that offers people quality care is something we should be delivering.
It is not rocket science.
It does not require massive investment.
It does require good leadership.
References:
1. Platt S, Arensman E, Rezaeian M (2019). National Suicide Prevention Strategies – Progress and Challenges (Editorial) Crisis 40(2) 75-82; Hogrefe Publishing.
2. Clinical Care and Intervention Task Force (2012). Clinical Care Intervention Report. National Action Alliance for Suicide Prevention sourced at https://theactionalliance.org/sites/default/files/clinicalcareinterventionreport.pdf
3. Department of Health (2017). Fifth Mental Health and Suicide Prevention Plan. Commonwealth Government of Australia, Canberra