Suicide Prevention in Primary Care: A Toolkit for Primary Care Clinicians and Leaders

Suicide prevention has been named a national priority and much work has been done to review existing evidence and identify gaps in how our nation’s mental health and health care systems address this public health challenge. A national task force that was part of the effort to update the national suicide prevention strategy reviewed research and best practices from the field and
concluded that suicide prevention could be improved in health care. The task force found three common characteristics among successful suicide prevention programs in health care settings. Health care staff in these organizations:
Believed that suicide can be prevented in the population they serve through improvements in service access and quality, and through systems of continuous improvement;
Created a culture that finds suicide unacceptable and sets and monitors ambitious goals to prevent suicide; and
Employed evidence-based clinical care practice, including standardized risk stratification, evidence-based interventions, and patient engagement approaches1.

The task force’s recommendations formed the foundation of the Zero Suicide Approach for health care organizations. The recommendations contained in this guide are based on those offered in the comprehensive Zero Suicide in Health and Behavioral Health Care Toolkit [http://zerosuicide.sprc.org/toolkit]. Here they have been adapted specifically for primary care organizations and clinicians who care for underserved populations.
The guide focuses on two core components:
1. Screening and assessment
2. Care management and referral processes
The final section contains some additional information on administrative and legal issues providers and leaders may find helpful to support integration of safer suicide care in practice. Many providers and clinical leaders erroneously assume if they discuss suicide with a patient they open up themselves to liability. Utilizing a patient safety approach, primary care organizations can
establish safer suicide care practices that deliver high quality care to patients and reduce risk to the organization.
In each section of this guide you will find:
Information summarized for providers, including some helpful provider communication tips.
A list of recommended trainings and resources to learn more.
Leadership actions organizations may wish to undertake to help providers reduce suicide in their organization’s
patient population, and
Relevant tools, templates and case studies.
This toolkit begins with a brief background on the impact of suicide and offers a case study illustrating how one federally qualified health center adopted a safer suicide care model.