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.
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.
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.
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.
Read our 2020 Yearend Report and press release to learn more about the achievements and findings of the third year in the largest effort in history to train primary care providers in suicide prevention—the Suicide Safer Care (SSC) program. Made possible by the support of the Centene Corporation and collaboration from Concert Health, ACU’s Suicide Safer Care initiative delivered 35 trainings to 1,704 participants in 16 states in 2020 to help address the public health crisis of suicide. Learn more.
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.
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 and other providers are particularly vulnerable to negative mental health effects and increased suicide risk during the COVID-19 pandemic, likely due to balancing the duty of caring for their patients and the concern for their own health and wellbeing and that of their friends and family. This training provides 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. Learn how to create a response plan that can be applied during the COVID-19 pandemic to help your organization help reduce the risk for suicide across your providers and team members.
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.
Request a Training or More Information About Suicide Safer Care
To request an organizational training or a printed copy of the Suicide Prevention in Primary Care Toolkit and for general inquiries regarding the SSC program, please contact Rick Brown, Manager, Programs, Membership, and Communications.