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Zero Suicide:
How do we make a
long-term difference?
DAVID W. COVINGTON, LPC, MBA
CEO & PRESIDENT, RI INTERNATIONAL
PUBLIC...
Big Hairy Audacious Goals
(BHAGs)
 Smallpox was eradicated in 1980.
 The five-year survival rates in 1975 of
certain for...
6380 Computer/web services
Target Zero and Performance
Improvement
4
Major Reductions
ZS Initiative Impact Status
US Air Force One-third reduction
over six years
1996 - 2002
Henry Ford Health...
6
“[At the start] there was a lot of debate about whether or not it
was even possible to reduce suicide through this type of...
8
Prominent suicidologists, argued successfully, albeit
erroneously, that this is not a healthcare issue. They kept
suicid...
9
Crossing the Quality Chasm
After becoming a finalist for a Robert Wood Johnson
Foundation grant, Don Berwick challenged ...
Prior to 2000, there was little research on crisis call center
effectiveness, and credibility was low. Since 2005, Link2He...
11
Reducing Both Death Rates and
Cost of Care
Arizona DHS and Magellan Health challenged the provider
network to eliminate...
12
The National Action Alliance for
Suicide Prevention
In 2012, the US Surgeon General and the National Action
Alliance pu...
In 2011, a task force of the National Action Alliance set out to
identify the best practice toolkit of interventions for c...
Between 1997 and 2006, mental health services implemented
recommendations to improve crisis and suicide care. While et
al ...
The Substance Abuse and Mental Health Service
Administration (SAMHSA) funds the first cohort of 16
organizations and 48 le...
The Suicide Prevention Resource Center develops a fidelity toolkit
and website to guide implementation, with seven key dom...
RFA-MH-16-800: Applied Research Toward Zero Suicide
Healthcare Systems (R01) - Applied research that advances the
Action A...
Leaders from New Zealand, the UK, the US and the
Netherlands met at IIMHL in Oxford, UK. Dutch psychiatrist Jan
Mokkenstor...
In September, a group of 50 service users from 13 countries,
healthcare providers and government policy makers convened
in...
20
In September, a group of 40 service users from 13 countries,
healthcare providers and government policy makers will
gather...
22
Zerosuicide.org
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Zero Suicide: How Do We Make a Long Term Difference?

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February 9, 2016 Hosted by Public Health England

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Zero Suicide: How Do We Make a Long Term Difference?

  1. 1. Zero Suicide: How do we make a long-term difference? DAVID W. COVINGTON, LPC, MBA CEO & PRESIDENT, RI INTERNATIONAL PUBLIC HEALTH ENGLAND ZERO SUICIDE FORUM FEBRUARY 2016 1
  2. 2. Big Hairy Audacious Goals (BHAGs)  Smallpox was eradicated in 1980.  The five-year survival rates in 1975 of certain forms of cancer, such as breast, prostate, and colorectal, were 75%, 69%, and 51%, respectively. In 2007, survival rates increased to 90%, 100%, and 67%, respectively.  And the incidence of polio has gone down dramatically since 1988, when over 350,000 cases were reported. In 2014, that number plummeted to only 359 reported cases, a 99% decrease. 2
  3. 3. 6380 Computer/web services
  4. 4. Target Zero and Performance Improvement 4
  5. 5. Major Reductions ZS Initiative Impact Status US Air Force One-third reduction over six years 1996 - 2002 Henry Ford Health System 75% reduction in first four years 2001 - Present Magellan Health in Arizona 38% reduction in first two years 2009 - 2013 Centerstone 65% reduction in first two years 2013 - 2016 5
  6. 6. 6
  7. 7. “[At the start] there was a lot of debate about whether or not it was even possible to reduce suicide through this type of an effort,” according to David Litts. “A lot of people, including mental health practitioners, were skeptical. But over a six-year period, the suicide rate dropped by one-third.” US Air Force Initiative 7
  8. 8. 8 Prominent suicidologists, argued successfully, albeit erroneously, that this is not a healthcare issue. They kept suicide out of the mental health Bible, the DSM, stating, “suicide is, by definition, not a disease, but a death that is caused by a self-inflicted intentional action or behavior.” Not a Healthcare Issue?
  9. 9. 9 Crossing the Quality Chasm After becoming a finalist for a Robert Wood Johnson Foundation grant, Don Berwick challenged the HFHS team to pursue perfection. A nurse staff member suggested that would mean zero suicide deaths. Within four years, their death rate had decreased by 75 percent.
  10. 10. Prior to 2000, there was little research on crisis call center effectiveness, and credibility was low. Since 2005, Link2Health has dramatically increased calls and capacity, started a Veteran’s hotline, added chat technology, and introduced best practice standards now utilized worldwide. 10 Standards, Training and Practices
  11. 11. 11 Reducing Both Death Rates and Cost of Care Arizona DHS and Magellan Health challenged the provider network to eliminate health plan suicides. In 2011, Behavioral Healthcare cited a 38% reduction in deaths, decreased hospitalizations and dramatic increases in staff confidence.
  12. 12. 12 The National Action Alliance for Suicide Prevention In 2012, the US Surgeon General and the National Action Alliance published a revised national strategy with new goals 8 and 9, calling for suicide prevention to become a “core component” of health care, and for improved professional and clinical practices, respectively.
  13. 13. In 2011, a task force of the National Action Alliance set out to identify the best practice toolkit of interventions for clinical care staff. The group was captivated by the cultural and system changes of the pioneers below, and designed and published a framework for replication. 13 A Systems Framework
  14. 14. Between 1997 and 2006, mental health services implemented recommendations to improve crisis and suicide care. While et al concluded that implementing these recommendations was associated with lower suicide rates in both cross-sectional and before-and-after analyses. The provision of 24 hour crisis care was associated with the biggest fall in suicide rates 14 While et al Study Evaluation Nine Recommendations
  15. 15. The Substance Abuse and Mental Health Service Administration (SAMHSA) funds the first cohort of 16 organizations and 48 leaders to develop implementation plans. Faculty include champions from IFH, Centerstone America and Group Health. The SPRC organizes and hosts the event. 15 Implementation Academies
  16. 16. The Suicide Prevention Resource Center develops a fidelity toolkit and website to guide implementation, with seven key domains: 16 Fidelity Toolkit
  17. 17. RFA-MH-16-800: Applied Research Toward Zero Suicide Healthcare Systems (R01) - Applied research that advances the Action Alliance's “Zero Suicide” goal for individuals receiving treatment within health care systems, needed to implement effective and comprehensive strategies in a variety of settings, including behavioral health and substance abuse outpatient clinics, Eds and crisis care programs and centers, hospitals, and integrated primary care programs 17 NIMH Research Grant
  18. 18. Leaders from New Zealand, the UK, the US and the Netherlands met at IIMHL in Oxford, UK. Dutch psychiatrist Jan Mokkenstorm: “We are at the beginning of this journey and start out from the core value that not one of our patients should die alone and in despair.” 18 1st International Summit (Oxford 2014)
  19. 19. In September, a group of 50 service users from 13 countries, healthcare providers and government policy makers convened in Georgia. The International Initiative for Mental Health Leadership match created an international consensus document and plan for expanding the social movement. 19 2nd International Summit (Atlanta 2015)
  20. 20. 20
  21. 21. In September, a group of 40 service users from 13 countries, healthcare providers and government policy makers will gather in Georgia. The International Initiative for Mental Health Leadership match will create an international consensus document and plan for expanding the social movement. 21 3rd International Summit (Sydney 2017)
  22. 22. 22 Zerosuicide.org

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