This document discusses bold new ideas for achieving zero suicides in healthcare settings. It outlines four key ideas: 1) including individuals with lived experience in leadership and design, 2) starting with the goal of zero suicides rather than incremental reductions, 3) having the goal emanate from organizational leaders, and 4) rejecting myths and truly believing that zero suicides can be achieved. It emphasizes that systems of care must do more to prevent suicide, which represents a failure in mental healthcare.

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Zero Suicide in
Healthcare: 4 Bold Ideas
DAVID COVINGTON, LPC, MBA—
RECOVERY INNOVATIONS, INC.

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Looking at Suicide Differently

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The Forgotten Patient

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Four Bold New Ideas
1. Include individuals with lived
experience in your leadership and
design
2. Start your goal from the other end
3. Your goal must emanate from the
leader (CEO, etc.)
4. Believe differently. Aspire for Zero.

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“Suicide prevention has not been
informed by peers who have
experienced the agony and decision-
making. They can provide support
that can be magic”
Eduardo Vega, MHA of San
Francisco

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Disease Transmission R Nought
Measles Airborne 12 – 18
HIV/AIDS Sexual
Contact
2 - 5
SARS Airborne
Droplet
2 – 5
Influenza Airborne
Droplet
2 – 3
Ebola Bodily
Fluids
1.5 – 2.5

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me too

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Four Bold New Ideas
1. Include individuals with lived
experience in your leadership and
design
2. Start your goal from the other end
3. Your goal must emanate from the
leader (CEO, etc.)
4. Believe differently. Aspire for Zero.

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6380 Computer/web services

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Four Bold New Ideas
1. Include individuals with lived
experience in your leadership and
design
2. Start your goal from the other end
3. Your goal must emanate from the
leader (CEO, etc.)
4. Believe differently. Aspire for Zero.

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“Over the decades, individual
[mental health] clinicians have
made heroic efforts to save
lives… but systems of care have
done very little.”
Richard McKeon, SAMHSA

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Four Bold New Ideas
1. Include individuals with lived
experience in your leadership and
design
2. Start your goal from the other end
3. Your goal must emanate from the
leader (CEO, etc.)
4. Reject myths. Aspire for Zero.

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“Suicide represents a worst case
failure in mental health care. We
must work to make it a ‘never
event’ in our programs and
systems of care.”
Mike Hogan, Former State
MH Commissioner

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Polling Question #1
Someone who died by hanging with their
hands bound behind their back and feet tied
together was probably a murder, not a
suicide.
A. True
B. False

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Group A Group B

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Depression is a disorder of mood, so
mysteriously painful and elusive in the way
it becomes known to the self — to the
mediating intellect– as to verge close to
being beyond description. It thus remains
nearly incomprehensible to those who have
not experienced it in its extreme mode.
- William Styron

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I finally succumbed when all my
strength was fully, completely gone…

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Suicide Can Be Prevented.
A. Never in Those Truly Intent on Suicide
B. Sometimes, but Only in Advance of Acute
Risk
C. Always, but Only in Advance of Acute Risk
D. Always, Even Up to the Last Moment

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Four Bold New Ideas
1. Include individuals with lived
experience in your leadership and
design
2. Start your goal from the other end
3. Your goal must emanate from the
leader (CEO, etc.)
4. Reject myths. Aspire for Zero.

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572,000
Hospitalizations**
752,000 Attempts
Requiring Medical Attention**
1,100,000
Suicide Attempts**
8,700,000
Seriously Considered Suicide**
38,364
Suicides*
Pyramid of Suicidal Behaviors

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6.8 to
10.5
10.6 to
13.9
14 to
16.9
17 to 23
23.2
20.1
14.0
14.5
10.6
13.9
16.9
10.5
6.8
Suicide Rates (2010 National
Average Rate 12.4)

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0
5
10
15
20
25
30
35
40
45
50
5-9 10-
14
15-
19
20-
24
25-
29
30-
34
35-
39
40-
44
45-
49
50-
54
55-
59
60-
64
65-
69
70-
74
75-
79
80-
84
85+
Rate/100,000
Age Group (Years)
White Male AI/AN Male Black Male
White Female AI/AN Female Black Female
Suicide Rates by Age, Race, &
Gender

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Learning Collaborative,
Julie Goldstein-Grumet
Learning Collaborative,
Meena Dayak
ZS Advisory Board (Mike
Hogan & David Covington)
3,802
2,507
1,123
6,292
1,562
6,816
771
6588,344
National Survey of 30,000 MH
Professionals Across Nine States

35. Question 16 of 16. (Behavioral Health)
35

36. Question 13. TRAINING (Behavioral Health)
36

37. Question 14. SKILLS (Behavioral Health)
37

38. Question 15. SUPPORT (Behavioral Health)
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The Air Force Did It

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Henry Ford Also Did It

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Magellan Health (Arizona)

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Magellan Health (Arizona)

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