Abstract of Distinction: Assessing Readiness of the Health and Behavioral Health Workforce to Provide Suicide Care: Findings from a Large-Scale Implementation of the Zero Suicide Workforce Survey

Introduction

Suicide is the tenth leading cause of death in the United States (CDC, 2015). The National Strategy for Suicide Prevention (HHS, 2012), prioritizes suicide prevention as a core responsibility of health and behavioral health (HBH) systems. In 2013, a task force of the National Action Alliance for Suicide Prevention published recommendations that operationalized suicide prevention in HBH systems. This led to development of the Zero Suicide framework, which is a systems-level commitment to preventing suicide deaths among all patients in care.

There are seven elements of Zero Suicide: (1) lead, (2) train, (3) identify, (4) engage, (5) treat, (6) transition, and (7) improve. To assist HBH organizations in adopting this approach, the Suicide Prevention Resource Center within EDC, Inc. developed a Zero Suicide Workforce Survey that HBH organizations can use to assess staff knowledge and comfort interacting with patients who may be at risk for suicide.

Methods

Between November 2016 and October 2017, 62 HBH organizations across 24 U.S. states and three countries registered to take part in the Zero Suicide Workforce Survey. A total of 11,418 individuals out of an estimated 16,638 workforce members (69%) completed the 66-item survey. The online survey took approximately 10-15 minutes to complete per respondent and included groups of items intended to assess knowledge, comfort, and skills across the elements of the Zero Suicide approach.

Results

Aggregate results from the survey revealed variation within and across Zero Suicide domains and by role of the respondent. For example, when assessing suicide prevention within their work environment, 91.7% believed that suicide prevention is an important part of their professional role (even among those respondents who do not directly interact with patients during their day-to-day duties). However, fewer than two-thirds reported that they received training at their organization on suicide prevention (64.9%) or had access to ongoing support and resources to further their understanding (66.3%). Among respondents who reported that they are responsible for providing clinical treatment to patients who have been identified as being at elevated risk for suicide, only half (51.5%) reported that they received training on suicide-specific evidence-based treatment approaches. Almost all respondents 91.3% identified at least one training need from a list of 20 categories (average = 7 identified needs).

Conclusions

Suicide is a pressing public health concern. The Zero Suicide framework is gaining traction among HBH organizations looking to implement system-wide changes to improve suicide care. Results from this survey provide a snapshot of the capacities and needs of HBH workforce members within organizations who have been early adopters of this approach.