Suicide Safer Care: Suicide Prevention in Primary Care
Primary care clinicians are confronting increasing concerns for patients that may be at heightened risk for suicide. Suicide is a growing public health crisis and the tenth leading cause of death in the United States. In 2018 alone, more than 48,000 individuals in the U.S. died by suicide—accounting for one death every 11 minutes. Despite efforts to lower this suicide rate, it increased 35% from 1999-2018, becoming the second leading cause of death for individuals between the ages of 10-34. The COVID-19 pandemic has only worsened this crisis.
Contrary to popular belief, less than half of deaths by suicide stem from mental illness or depression. Rather, deaths by suicide stem from a variety of factors such as relationship issues, life crises, substance use disorder, or illnesses. The link between suicide and these social determinants of health—and the fact that 45% of individuals who die by suicide visited their provider in the month before their death—suggests that primary care providers are in a position to identify patients at risk of suicide and intervene during primary care visits.
Using the Zero Suicide framework as a foundation and with the generous support of the Centene Corporation, ACU created the Suicide Safer Care curriculum to train primary care providers and their teams on skills for suicide risk assessment, evidence-based interventions, referral and transition when needed, and changing the culture of addressing suicide risk across clinical practice. In 2020, ACU’s Suicide Safer Care initiative delivered 35 trainings to 1,704 participants in 16 states to help address the public health crisis of suicide, and responses from participating providers demonstrated tremendous gains in knowledge and level of comfort in assessing and caring for patients at risk of suicide after completing the training.
Toolkits, Fact Sheets, and Other Resources
The Suicide Prevention in Primary Care toolkit provides guidance on the four core components of how health care professionals can help identify and prevent suicide in patients, create cultures of practice that find suicide unacceptable and set ambitious goals to prevent suicide, and employ evidence-based clinical practices that standardize risk stratification, evidence-based interventions, and patient engagement approaches. Read the guide to learn best practices for:
- screening and identifying and assessing patients at risk for suicide,
- restricting access to lethal means and safety planning,
- and caring for patients at risk of suicide.
Suicide Safer Care: A Toolkit for Pediatric Primary Care Providers & School-Based Health Centers addresses the growing crisis of pediatric suicide. Suicide is the second leading cause of death in youths aged 10-24, and rates of suicide among Black youth aged 13 and younger are twice that of White youth. However, health center providers have a crucial opportunity to intervene and help prevent pediatric suicide. Read the guide to learn about:
- The scope and reality of the pediatric suicide crisis,
- common risk factors and warning signs,
- and screening tools, clinical pathways, and evidence-based interventions.
Suicide Safer Care: A Toolkit for Primary Care Providers Working with Geriatric Patients addresses the alarming prevalence of elder suicide. Elderly individuals are the greatest risk for completed suicide of all age groups in the United States, and in 2020, 25 people over the age of 65 died by suicide every day. However, primary care providers working with elderly patients at health centers and elsewhere have vital opportunities to intervene Read our guide to learn about:
- Unique considerations in geriatric suicide and depression,
- common risk factors and warning signs,
- and screening tools, clinical pathways, and evidence-based interventions.
Organizational Approaches to Address Suicide Risk in Healthcare Professionals examines the scope of suicide risk in healthcare professionals and provides organizational approaches to support primary care providers and team members while reducing suicide risk. This fact sheet provides:
- an overview of suicide risk in healthcare team members including physicians, nurse practitioners/physician assistants, and nurses,
- Suicide Safer Care strategies for managerial training to address suicide risk, approaches to creating cultures of wellness, and postvention strategies to support survivors of deaths by suicide.
Shareable Video, Graphics, Messaging, and More
In honor of National Physician Suicide Awareness Day (#NPSADay) on September 17, the Association of Clinicians for the Underserved has developed helpful social media resources to help you and your organization raise awareness of the crisis of clinician suicide.
Healthcare professionals in training who will be entering primary care settings are likely to encounter patients at risk for suicide: nearly half of all individuals who end their lives by suicide visit a primary care provider (PCP) in the month before their passing. However, medical students and other clinicians in training often receive little training in prevention. Simple strategies can help save lives, and ACU’s latest Suicide Safer Care guide, “Quick Tips for Medical Students and Other Primary Care Professionals in Training,” provides an introduction to elementary suicide prevention strategies that clinicians can integrate in primary care visits. Read the guide to learn:
- How to recognize warning signs,
- Screen for suicide and assess risk,
- And make evidence-based interventions.
The COVID-19 pandemic, both in its onset and in the continuing uncertainty of the Delta variant, has significantly impacted the social determinants of health, stressful life events, and mental health symptoms that are each associated with suicide risk. ACU’s latest publication addresses COVID-19’s effects on suicide prevention and how our community can take action. The new fact sheet provides an introduction to how COVID-19 has affected social determinants of health and suicide prevention, as well as practical steps that providers and health centers can take to address suicide risk during the pandemic.
Archived Suicide Prevention Webinars
This webinar with ACU, Dr. Virna Little, and Dr. Ursula Whiteside offers information on providing primary care to patients at risk for suicide, identifying patients in your practice as well as information on “language matters.” Providers and their teams can learn some “micro interventions” to use during a primary care visit, risk assessments and safety planning.
Simple Steps to Help Save Lives: Practical Suicide Prevention Strategies for Primary Care Professionals in Training
Suicide is a growing public health crisis, and medical students and other clinicians in training who will be entering the primary care space are likely to encounter patients at risk for suicide. Nearly half of individuals who end their lives by suicide visit a primary care provider in the month before their passing, making primary care visits crucial opportunities to intervene. However, all too many clinicians receive no training in suicide prevention during their education. The Association of Clinicians for the Underserved has developed a new “Quick Tips” guide to help prepare clinicians in training with simple, practical strategies and micro-interventions that can be seamlessly incorporated into any primary care visit. Join Dr. Virna Little, Chief Clinical Officer at Concert Health, and Dr. Julian Mitton, General Internist and Addiction Medicine Physician, Clinical Assistant Professor, Baylor College of Medicine, to understand the scope of the crisis, learn to recognize warning signs and screen for suicide, and implement simple, evidence-based interventions.
COVID-19 is exacerbating risk factors for suicide, which is being reflected in significant increases in calls to local and national suicide hotlines. Many patients who die by suicide visited their primary care provider within the month of their death, and most were not connected to mental health treatment. As such, primary care providers and their teams are in a unique and critical position to identify and care for patients at risk for suicide.
This training provides concrete steps for primary care providers to identify and care for patients at risk for suicide. Providers will learn how, during the course of any primary care visit (including telephonic visits), to provide suicide safer care and gain a greater understanding of suicide and risk. Join this informative webinar, and a community of over 1500 primary care providers and their teams who have been trained to date, to gain practice tips and knowledge on how to provide evidence-based primary care treatment to patients at risk for suicide.
Physicians are significantly more likely to die by suicide than the general population, and an estimated 300 physicians die by suicide in the United States every year. The COVID-19 pandemic has exacerbated the stress, burnout, and fatigue already felt by many physicians, providers, and other healthcare professionals balancing the duty of caring for patients with concerns for their own health and wellbeing. Despite these challenges, many do not seek treatment or support for fear of stigma or professional repercussions. Along with its accompanying fact sheet, this training provided specific Suicide Safer Care techniques to help support your primary care providers and team members through systematic and organizational approaches to address suicide risk and prevent deaths by suicide among employees.
Caring for the Healers Pt. III: Preventing Suicide in Healthcare Professionals and Staff and Navigating Postvention
Healthcare professionals are significantly more likely to end their lives by suicide than the general population. The COVID-19 pandemic and other events have only exacerbated the stress, moral injury, and fatigue already felt by many healthcare professionals balancing caring for patients with concerns for their own wellbeing. And when healers end their lives by suicide, these tragic incidences can also have a “ripple effect,” increasing the vulnerability of other professionals, patients, and family members. Join Dr. Virna Little, Chief Clinical Officer at Concert Health, and Sarah A. Bernes, consultant and behavioral health expert, to understand the dynamics of the crisis and learn concrete strategies to help support primary care providers and teams, address suicide risk and prevent deaths by suicide in staff, and implement effective postvention strategies.
Pediatric Suicide Prevention for Primary Care Providers and School-Based Health Centers: A Suicide Safer Care Approach
The crisis of pediatric suicide in the United States is growing. Suicide is the second leading cause of death in youths aged 10-24, with the fastest-growing rates among youth ages 10–14. Furthermore, the crisis is marked by significant racial disparities. However, primary care providers at school-based and other health centers have a crucial opportunity to intervene, and ACU recently developed a new pediatric suicide prevention toolkit for such providers. In this free accompanying webinar, drawing on the new publication and other resources, presenters provided an overview of the crisis and why providers can play an important role in prevention, discussed common warning signs and risk factors, and detailed effective pediatric suicide prevention practices include screening tools such as the PHQ-A and ASQ, as well as clinical pathways and evidence-based interventions.
Geriatric Suicide Prevention: Suicide Safer Care Principles for Primary Care Providers and Their Teams
Suicide in elderly populations is a major public health issue. People aged 85 years and older have some of the highest suicide rates of any age group in the U.S., and older adults who attempt suicide are more likely to complete these attempts than others. Additionally, the COVID-19 pandemic has only exacerbated existing risk factors, such as social isolation, depression, and family discord or loss. However, primary care providers and their teams which work with geriatric populations have a critical opportunity to intervene. Learn how Suicide Safer Care principles can help prevent elder suicide in our archived webinar featuring experts from Concert Health and Adelphi University. This discussion explores the dynamics of geriatric depression and suicide and why providers can play important roles in prevention and detail effective suicide prevention practices for geriatric populations, from screening tools to evidence-based interventions.
How Primary Care Providers Can Help Prevent Elder Suicide: A New Guide to Geriatric Suicide Safer Care
Elderly individuals are the greatest risk for completed suicide of all age groups in the United States, and in 2020, 25 people over the age of 65 died by suicide every day. Furthermore, geriatric depression and suicide risk often go under-identified and treated in primary care. However, primary care providers working with elderly patients at health centers and elsewhere have vital opportunities to intervene, and the Association of Clinicians for the Underserved has developed a new geriatric suicide prevention toolkit to help. Our webinar with Dr. Virna Little, nationally known suicide prevention expert and Zero Suicide faculty member, provided an understanding of unique factors in geriatric suicide and depression and how providers can act for prevention. Drawing on our publication, the webinar details common warning signs and risk factors, as well as effective geriatric suicide prevention practices and evidence-based interviews.
Request a Training or More Information About Suicide Safer Care
To request a training or technical assistance, or for general inquiries about the SSC program, please contact Rick Brown, Associate Director of Communications and Membership.