Zero Suicide Model Implementation and Suicide Attempt Rates in Outpatient Mental Health Care

Area of Science:

• Public Health
• Health Services Research
• Mental Healthcare

Background:

• Suicide is a significant public health issue, necessitating effective prevention strategies within healthcare systems.
• The Zero Suicide (ZS) model is recommended for suicide prevention in health systems, but requires further evidence for broad implementation.

Purpose of the Study:

• To evaluate the impact of the Zero Suicide (ZS) model on suicide attempt rates in outpatient mental health care.
• To assess the association between ZS model implementation and suicide attempt rates across six US health systems.

Main Methods:

• A quality improvement study utilizing an interrupted time series design.
• Data collected from January 2012 to December 2019 from patients aged 13+ in outpatient mental health specialty settings.
• Compared suicide attempt rates before and after ZS model implementation, including screening, assessment, and intervention protocols.

Main Results:

• Suicide attempt rates decreased at three of the four intervention health systems post-ZS model implementation.
• Specific reductions observed: Health systems A and B by 0.7/100,000/month, System C by 0.1/100,000/month.
• Two systems showed reductions in suicide death rates following ZS model implementation.

Conclusions:

• Implementation of the Zero Suicide (ZS) model in outpatient mental health care settings was linked to reduced suicide attempt rates.
• Findings support the broader adoption of the ZS model within US health systems for suicide prevention.