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Seven Years of Success for Zero Suicide Initiative

September 19, 2022

Seven years after joining 19 other organizations worldwide as the first to train through the Zero Suicide Academy, Hartford HealthCare efforts have expanded across the system to involve hundreds of colleagues. The Zero Suicide initiative, stewarded by Hartford HealthCare’s Behavioral Health Network (BHN), focuses on effectively assessing and following up on patients at risk of suicide. Marissa Sicley-Rogers, PsyD, operational lead for the initiative, presented telling statistics as part of a recent World Suicide Prevention Day program.

Train teams

One key accomplishment, Dr. Sicley-Rogers said, are the trainings for colleagues in and beyond the BHN to help people at risk of suicide. Successes include:
  • 581 BHN colleagues completing a four-hour Suicide Assessment Model (SAM) training.
  • 120 more undergoing two-hour SAM refresher trainings.
  • 1,141 Hartford HealthCare employees beyond the BHN training in a gate-keeper training, Question Persuade Refer (QPR).

Identify risk

Efforts to help colleagues identify suicide risk also increased, despite challenges posed by the pandemic, Dr. Sicley-Rogers continued. When in-person sessions proved unlikely, the Zero Suicide team adapted efforts to telehealth, she said. “The Suicide Risk Assessment Module is an Epic tool encompassing suicide screening, comprehensive risk assessment, clinical decision support and effective documentation,” she said, referring to Hartford Healthcare’s electronic medical record.

Engage those at risk

The third accomplishment Dr. Sicley-Rogers offered were efforts to engage people at risk of suicide through various means, meeting them where they are and forming care partnerships. From May 2020 to July 2022, she said:
  • 20 BHN sites joined engagement efforts.
  • 1,025 lockboxes were provided so people can secure items that might be used for self-harm.
  • 931 at-risk individuals and families received Counseling on Access to Lethal Means (CALM).
  • Safety planning was initiated with at-risk individuals and their families to help them manage stressful situations.

Caring connections

To improve the experience of people transitioning to different levels of behavioral healthcare and ensure they connect with helpful community resources, Dr. Sicley-Rogers said the Zero Suicide team devised post-discharge Caring Connections Calls. “These are made to help clients transition, follow up on missed appointments and check in on those identified as being at higher risk for suicide,” she said. Such calls are now in use across the BHN, including on inpatient BHN units at acute care hospitals. “Compliance in completing these calls on all BHN inpatient units increased 33% from July 2020 to July 2022,” Dr. Sicley-Rogers said. In addition:
  • Quarterly ligature rounds at each BHN entity yielded more than 650 safety concerns that were identified and corrected between 2019 and 2022.
  • Annual risk assessments were launched at outpatient BHN facilities.
  • A workforce survey revealed 334 colleagues had lost a client to suicide, and half of them had lost more than one. This finding underscores the need for our Postvention Team, a group deployed to support colleagues after a suicide loss of a client, Dr. Sicley-Rogers said.

‘Our work is not done’

Despite such advances, she said work continues, especially since suicide attempts increased so far this year. In 2023, she said the Zero Suicide initiative team plans to:
  • Launch Zero Suicide annual required learning for all Hartford HealthCare colleagues
  • Expand delivery of lockboxes and CALM across BHN entities to all programs
  • Increase representation of individuals with lived experience in the governance structure
  • Continue to establish a national presence with our Zero Suicide work
For more information about the HHC BHN Zero Suicide initiative or how to join, please contact: Marissa.Sicley-Rogers@hhchealth,org