Get Support from Leadership

One of the main steps in building a successful suicide prevention program is to get support from senior leaders of the organization. The following components can help build a foundation of support:

  • Identify champions who represent multiple disciplines and diverse backgrounds to move the program forward
  • Involve all healthcare staff (physicians, nurses, medical assistants/technicians, social workers, behavioral health professionals, front-desk workers, environmental services staff, etc) in the suicide prevention program
  • Secure sustained buy-in from senior leadership is crucial for a plan’s longevity. Any changes in senior leadership or champions should be accompanied with transition plans so suicide prevention programs do not falter or discontinue because of staff departures
  • Involve youth, parents/caregivers, or families early in the process for feedback, particularly those with lived experience of suicide

Assign Roles

Staff from different disciplines can take on various roles in suicide prevention initiatives. These roles may vary between settings. Health systems can assign roles based on available staff and resources:

  • Nurses and medical assistants/technicians can be trained to administer screening tools during initial nursing assessments or at triage
  • Physicians, nurse practitioners, physician assistants, social workers, and other mental health clinicians can be trained to administer brief suicide safety assessments (see Clinical Pathways)
  • Office staff can be trained in support roles, such as handing out screening forms and telling parents/caregivers that they will communicate questions to the clinical staff

Collaborative or integrated care models present a promising method to connect medical patients with mental health resources. These models may:

Connect with Mental and Behavioral Health Providers in your Community

When planning to integrate a suicide prevention protocol in your clinic, it is critical to first identify mental and behavioral health providers in your community, build connections with those providers, and identify alternate strategies for communities that have a lack of mental health resources. See Two Critical Steps Before You Begin for full details.

Build a Suicide Prevention Program that Best Serves your Community of Patients

Individual communities experience and discuss mental health, distress, and suicide in different ways. Terms used to talk about death or suicide may vary by population and culture, and beliefs or stigmas about mental health may impact delivery of patient care.

Partnerships with community members are critical to building effective suicide prevention programs:

  • Engage community/tribal leaders, youth, and parents/caregivers from the beginning, to identify needs and desires for suicide prevention and mental health services among your patient population
  • Youth and families with lived experience of suicide are especially important collaborators to engage in the design of programs. Learn more about safely engaging people with lived experience here
  • Partner with community/tribal members, faith leaders, and school leaders in the implementation of your suicide prevention program, as care navigators, clinic staff, or peer educators

Health systems can build an inclusive and welcoming care environment for their patient community:

  • Use inclusive language in office signage, forms, and clinical interactions
  • Ask patients about their names and pronouns and avoid gendered language in clinical discussions
  • Display signs or printed materials in the language(s) spoken by the patient population
  • Ensure that posters and photographs in the office reflect a diverse range of families and patients
  • Display posters or signs conveying that patients and families deserve to feel welcome and respected
  • Seek feedback from patients and families about the physical environment of the clinic
  • Ensure clinic documents are professionally translated into the languages spoken by your patient population
  • Utilize an interpreter during clinical visits with patients who speak a language other than your own. Ensure that family members of the patient are not asked to serve as interpreters
  • In telehealth visits, utilize interpreters and assistive technology to promote accessibility for all families

Assess and Address Barriers

Barriers can be overcome, but they are also real issues that need to be addressed by each institution. Understanding common barriers to suicide prevention protocols can help health systems overcome potential roadblocks. Barriers can be addressed through staff training and by adapting the evidence-based clinical pathway below to meet the individual needs of your practice.

Train the Staff

All staff should be involved in suicide prevention training. Training can build skills, confidence, and self-efficacy in staff and can help staff communicate compassionately and more effectively with parents, caregivers, and families.

Interactive training strategies, such as role-plays, standardized patients, or peer feedback on skills and techniques may help staff understand and integrate this content into practice.

Training programs should address the following topics:

  • Epidemiology of suicide among youth and young adults
  • Addressing common myths and stigma related to suicide
  • Specific training in how to use the screening and assessment tools that will be used by your health system (see Screening and Assessment tools)
  • Knowing what to say and do (and what not to say or do) when a patient reports suicidal thoughts or behaviors
  • Trauma-informed care
  • Safety planning
  • Lethal Means Safety Counseling
  • Understanding the impact of a suicide loss on child/youth mental health
  • Understanding the impact of a suicide loss on healthcare professionals
  • Billing procedures (including CPT codes and payments)
  • Working with interpreters
  • Confidentiality practices and limits for adolescent healthcare
  • Rare emergencies, such as patients at imminent risk for suicide
  • Regulatory procedures (The Joint Commission, insurance, state requirements)
  • Maintenance of Certification and quality improvement strategies for implementation
  • Health equity and cultural considerations for care provision
  • Understanding and addressing personal and systemic biases that impact care delivery

To promote a program’s longevity, training should be repeated regularly for all staff, and updated as new information becomes available. During leadership transitions or when onboarding new employees, suicide education and prevention training should be incorporated into the training process for smooth transitions. 

Experts are available to train your health system staff in person, online, or via recorded trainings:

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American Academy of Pediatrics