Zero Suicide is a commitment to suicide prevention in health care systems and is also a specific set of strategies.

Listen to our Executive Director, Dr. JoEllen Tarallo – along with Dr. Stephen Broer, Director
of Behavioral Health Services at Northwestern Counseling & Support Services –
discuss suicide prevention strategies in this live interview with Vermont Public Radio.

Most people who are at risk for suicide feel suicidal for only a brief period in their lives. With proper assistance and support, they will probably never be suicidal again.

Girl Faded Help-sm

Vermont is taking up a commitment to suicide prevention in health and mental health care systems, by promoting a set of tools and strategies called, “Zero Suicide.” The core proposition is that suicide is preventable and that the bold goal of zero suicides among persons receiving care is a challenge that health systems should accept.

Zero Suicide is a system-wide approach to improve suicide outcomes and close gaps by training staff to be proficient in assessment, identification, referral and treatment, and by tightening linkages between elements of the system – supported by timely and effective follow up at each point of patient contact.

A Zero Suicide approach was created by the Behavioral Health Services division of the Henry Ford Health System in 2001. The most common cause of suicide is depression. The Henry Ford Health System developed the Perfect Depression Program in which primary care doctors screen every patient for depression, and if indicated, suicide specifically. If the health providers recognize a mental health problem, patients are assigned to appropriate care — cognitive behavioral therapy, drugs, group counseling, or hospitalization if necessary. On each patient’s medical record, providers have to attest to having done the screening, and they record plans for any needed care. Therapists involve patients’ families, and ask them to remove guns or other means of suicide from their homes. Clerks are trained to make sure that patients who need follow-up care don’t leave without an appointment. Patients themselves come up with “safety plans.”

With a relentless focus on finding and treating people with depression and adhering to a strict and specific approach that screened and assessed for suicide, the Henry Ford Health System cut the suicide rate among the people in its insurance plan dramatically. The rate of suicide in Henry Ford’s patient population decreased by 75 percent in the first four years of the program’s implementation – from 89 per 100,000 patients to 22 per 100,000. Over a two and a half year period starting in 2010, that rate went down to zero per 100,000. This remarkably low rate of patient suicide stands in marked contrast to an expected rate of 230 per 100,000 as reported from scientific research.

Using the successful Zero Suicide approach as the basis for our work in Vermont, the VT Department of Mental Health and VT Suicide Prevention Center are moving forward with training clinicians in suicide specific assessment and treatment, and developing policies, protocols and data collection that support a consistent system of care.

“Why push for zero, rather than just a reduction? “Because if you say we’re OK with five a year, one of those might be your brother or your friend. We aim for zero because it reminds all of us of what we would want for ourselves.”  (See

Along with developing effective outreach and treatment for people at risk for suicide, suicide attempt survivors are starting to speak about their experiences. They are reporting that with caring outreach from family, friends and providers, and identification, treatment and support, they can learn to live and thrive, in spite of the mental or physical health challenges they may face.

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