A Life Worth Living: Zero Suicide Initiative Focuses on Helping At-Risk Patients

September 13, 2017

Suicide prevention is a topic that’s very close to Patricia Hayward-Paige’s heart.  The Natchaug pharmacy technician lost a close friend to suicide nearly 20 years ago.

“She made an attempt and was unsuccessful. I was able to get her to a hospital and get her some help. She moved back to California, tried again and succeeded because no one there knew she was having a problem,” says Hayward-Paige.

Hayward-Paige’s experience has made her determined to help those who might be thinking about suicide.  She and 19 other of her Natchaug colleagues, both clinical and non-clinical, are serving as Zero Suicide Champions, working as a group to find safer, more effective suicide prevention approaches.

It’s just one part of the Hartford HealthCare Behavioral Health Network’s implementation of the Zero Suicide initiative, a system-wide, evidenced-based approach to establish more focused assessment and timely follow-up care for patients who are at risk of suicide.

In 2015, the Institute of Living was one of the first 20 organizations worldwide to be accepted into and trained by The Zero Suicide Academy, a two-day training for senior leaders of health and behavioral health organizations seeking to reduce suicide among patients in their care.  Natchaug, Rushford, Backus Hospital, and the Hospital of Central Connecticut began Zero Suicide implementation in 2016.

Learn more about the ZERO Suicide initiative at Hartford HealthCare:


“This is a very comprehensive and methodical way of addressing prevention,” says IOL Medical Director Linda Durst, MD, who is leading the overall effort.  “Before [Zero Suicide], there was an assumption that staff members were trained to assess for suicide risk and knew exactly how we should treat patients at risk. [In the past,] patients at risk were given an assessment but no one was really sure if we were using the results effectively in our efforts to prevent suicide.”

Under the Zero Suicide initiative, patients are assessed using the highly regarded Columbia Suicide Severity Rating Scale (C-SSRS). C-SSRS uses a series of simple plain language questions asking the patient, for example, whether and when they have thought about suicide; what actions they have taken to prepare for suicide; and whether and when their attempted suicide was either interrupted by another person or stopped of their own volition.  C-SSRS will be rolled out across Hartford HealthCare this year.

Zero Suicide also focuses on training clinical and non-clinical staff, evidenced-based treatments focusing explicitly on suicide risk, establishing policies to ensure safe handoffs between caregivers, and effective engagement of patients at risk including a follow-up phone call within 24 hours after discharge.

“It’s a high-risk period. Just reaching out and making that call dramatically reduces the risk of suicide,” says Deborah Weidner, MD, MBA, East Region Behavioral Health Network Medical Director and BHN Vice President of Patient Safety and Quality

At Rushford, Medical Director J. Craig Allen, MD, says the hospital’s highest risk patients are those discharged from their detox program.  He says these are the patients who get next day follow-up phone calls.

“The population that suffers from substance abuse disorders is at an extremely high risk of suicide because of the nature of the substances, which can increase the rates of depression, decrease inhibitions, and increase impulsivity.  And the one variable that’s most highly correlated with suicide is alcohol,” Allen adds.

Dr. Weidner says staff engagement in the Zero Suicide initiative is a key to its success and that many staff members, like Hayward-Paige, have answered the call.

“For me, if I can help one person by volunteering to be part of this group then it’s worth it,” says Hayward-Paige.