Zero Suicide enables best practice in suicide risk screening and assessment, risk formulation, and safety planning (https://zerosuicide.sprc.org/). The foundational belief of Zero Suicide is that suicide deaths for individuals under the care of health systems are preventable. It presents both a bold goal and an aspirational challenge. The need for improvement at a system level is underscored by the sobering statistics on suicide, the 9th leading cause of death in Canada. In the month prior to dying by suicide, 45% of patients saw their primary provider and 30% were seen by a mental health clinician. The programmatic approach of Zero Suicide is based on the realization that suicidal individuals often fall through the cracks in a sometimes fragmented health care system. A systematic quality improvement approach in these settings is necessary. Implementation of Zero Suicide cannot be borne solely by the practitioners providing clinical care, it requires a system-wide approach that actively includes patients and caregivers, to improve outcomes and close gaps. Other critical aspects include commitment from leadership, support during high-risk times of transition, support for staff – both psychosocial and specific skills training, and the use of evidence-based treatments that directly target suicidality. St. Josephs Health Care London is the first organization in Canada to systematically implement this model, which is also currently being implemented all across the United States, the United Kingdom, Australia and parts of Europe. Zero Suicide has been endorsed by the Ontario Hospital Association and the Mental Health Commission of Canada as leading practice.
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