Julie Goldstein Grumet, PhD
VP, Suicide Prevention Strategy and Director, Zero Suicide Institute
Education Development Center

September is Suicide Prevention Month

Suicide is the 10th leading cause of death in the United States, and suicide death rates are rising. There were almost 49,000 deaths by suicide in 2024. However, suicide deaths alone are not sufficient in considering the damage caused by suicidality on society. The National Survey on Drug Use and Health (NSDUH) data suggest that 2,553,000 American adults and teens attempted suicide in 2022 and more than 16,600,000 Americans reported serious thoughts of suicide (SAMHSA, 2023). 

Providers enter the healthcare profession with the desire to improve the lives, health, and wellbeing of their patients. The death of even one person by suicide leaves a profound and lasting impact on families, loved ones, and the healthcare professionals who provided care. September is Suicide Prevention Month, an opportunity to reflect on both how to ensure that individuals at risk receive high quality, effective treatment as well as acknowledge and honor the hard work of providers who deliver this care.

Adopting Zero Suicide

The Zero Suicide model was developed and released approximately 15 years ago based on the recognition and evidence that effective practices to reduce suicide deaths and despair were now available for healthcare systems to implement. Zero Suicide is a quality improvement framework that transforms system-wide suicide care, establishing suicide prevention as a core healthcare responsibility in the U.S. (National Action Alliance for Suicide Prevention, 2012). Seven core elements comprise the model: “Lead,” “Train,” and “Improve” are the structural components embedded throughout the system and necessary for change success, fidelity, and continuous quality improvement. “Identify,” “Engage,” “Treat,” and “Transition” are clinical components of the model and define the care patients should receive. Used together and continuously, healthcare systems that have adopted this model have seen reductions in suicide deaths and improved wellbeing among patients. More than 2,000 healthcare settings worldwide have adopted Zero Suicide; however, fidelity to the model varies widely and its potential to transform outcomes remains underrealized.

The premise of Zero Suicide is that suicide prevention requires system-wide changes to existing culture, policies, training, and practices. Zero Suicide emphasizes a culture of safety and prevention where suicide prevention is the responsibility of all workforce members within an organization, independent of their role, and reinforced through supportive leadership, training and support to staff who do this demanding work, clear protocols and care pathways, and the use of clinical care best practices.

Zero Suicide is also inherently a continuous quality improvement (CQI) model, designed to evolve and strengthen over time. Rather than viewing suicide care as static, Zero Suicide promotes ongoing measurement, evaluation, and iterative change. Organizations are encouraged to track process and outcome metrics to understand system performance and identify areas requiring improvement. This data-driven approach shifts the focus from isolated clinical decisions to patterns, trends, and systemwide learning. By merging clinical excellence with systemwide quality improvement, Zero Suicide positions healthcare organizations to pursue the aspirational—but actionable—goal of eliminating suicide deaths among those in their care.

Inpatient Toolkit

EDC's Zero Suicide Institute recently released an inpatient-focused toolkit to support healthcare systems to integrate Zero Suicide principles into daily practice—offering structured tools, recommendations, and examples from organizations that have achieved measurable results. While most inpatient hospitals already have suicide prevention protocols in place, the Zero Suicide framework helps organizations go beyond compliance with the goal by adopting best practices, a systemic approach, and a culture committed to eliminating suicide for those in care. To ensure safer care, inpatient teams must consistently:

• Conduct thorough, evidence-based suicide risk screenings, assessments and frequent reassessments.
• Develop collaborative, patient-centered safety plans.
• Engage family members and support systems.
• Provide access to suicide-specific therapeutic interventions.
• Design strong transition plans to ensure continuity of care after discharge.

For healthcare systems interested in adopting Zero Suicide, consider starting by taking the Inpatient Organizational Self-Study. 

Supporting Parents

Parents are a critical partner to healthcare providers in caring for youth following their suicide attempts. Share this thoughtful resource with them that answers many frequently asked questions about their child’s suicidality and provides them with a roadmap to support them: Supporting Parents | Zero Suicide. Many healthcare professionals have limited training in delivering suicide-specific care. Asking your staff to take this workforce survey can help you to create an action plan to support your team and ensure they feel comfortable and confident to care for patients thinking about suicide.  Join this national listserv of Zero Suicide implementers, researchers, individuals with lived experience, and others to ask your own questions and trade tips and resources.

The Zero Suicide model represents a galvanizing but feasible approach for identifying and caring for people at risk for suicide. Reorienting health care to prioritize and reimagine the delivery of suicide care practices is at the core of Zero Suicide. EDC's Zero Suicide Institute team is available to answer your questions about suicide care and support your journey.