Suicide Prevention as Quality Healthcare

September is Suicide Prevention Month. At Array Behavioral Care, we embrace the Zero Suicide Model as a cornerstone of our high-quality mental health services. This evidence-based approach, endorsed by leading public health agencies, transforms suicide prevention into a system-wide commitment across all levels of care.

Implementing Suicide Prevention Across Care Settings

From primary to acute care, implementing universal screening and comprehensive care strategies can be lifesaving.

Suicide is preventable, not inevitable. The first step is asking.

Overcoming Barriers to Suicide Prevention

Contrary to common misconceptions, talking or asking directly about suicide does not increase distress or prompt suicidal thoughts.

Studies show that most at-risk patients do not require immediate hospitalization; instead, they would benefit from safety planning and access to mental healthcare services. The right screening approach connects individuals to quality care that meets their specific needs.

"Suicide screening needs to become a part of routine primary healthcare, like listening to someone’s heart," said Mark Alter, MD, PhD, Senior Vice President and Chief Medical Officer of Acute Care with Array.

Evidence Supporting the Zero Suicide Model

The sad reality is that the vast majority of individuals who die by suicide have visited a healthcare provider in the year before their death – many within 30 days according to one study. Universal screening in medical settings, a pillar in the Zero Suicide Model, is designed to identify at-risk individuals and route them to appropriate care.

By addressing the whole patient, this approach can enhance the quality of healthcare overall.

The Joint Commission, an independent organization that accredits hospitals nationwide, sounded the alarm in 2010 on suicide screening by frontline healthcare providers.

A 2015 study found that screening all emergency department (ED) patients, regardless of the reason for their visit, doubled the number of patients identified as being at risk for suicide. By incorporating these screenings, an estimated 3 million additional adults at risk for suicide could be identified each year.

Closing Dangerous Gaps in Screening

Research published in 2024 by The Joint Commission found that most hospitals were not fully complying with suicide prevention policies. According to their survey of nearly 1,500 hospitals:

• 61% conduct formal safety planning
• 37% provide warm handoffs to outpatient care
• 30% follow up with patients after discharge
• 28% provide lethal means safety planning

These gaps, often linked to limited resources and staffing, highlight the need for specialist support to achieve comprehensive suicide prevention. Telehealth behavioral care solutions like those offered by Array can help healthcare facilities standardize and expand their suicide prevention efforts.

Array’s Approach to the Zero Suicide Model

As a leader in suicide prevention, Array employs a tiered suicide screening process using evidence-based tools:

1. Brief PSS-3 screening for all patients
2. ESS-6 for more detailed assessment if initial concerns arise
3. Stanley-Brown Safety Planning Intervention for higher-risk individuals

"We encourage all healthcare providers to consider integrating these tools into patient care to help close gaps in suicide prevention," said Marlene McDermott, LMFT, PhD, VP, Therapy and Quality Services with Array. "There are significant advantages to having trained mental health professionals administer these screenings because they can bring their expertise to sensitive conversations."

This comprehensive system ensures appropriate care and support based on specific risk level. Explore more in our brief guide on suicide prevention screening tools implemented by Array.

Providing Right Care at the Right Time

While identifying suicide risk is critical, it is equally important to provide the appropriate level of care. Governing bodies require risk stratification because treating all patients the same way, regardless of their risk level, can overwhelm the emergency department and divert resources.

Comprehensive psychiatric assessments reduce unnecessary hospital stays, which can worsen patients’ symptoms A study published in 2023 found suicide screening policies increased the demand for psychiatric evaluation. But they also led to more patients being safely discharged home, without increasing the length of stay. “Based on these results, efficient suicide screening may help identify at-risk individuals without overwhelming psychiatric resources,” the study authors concluded.

Array takes the added step of collecting collateral information from caregivers and family members, offering insights that the patient might not disclose. This holistic approach ensures that care is tailored to everyone's needs.

Continuous Support Beyond Hospital Walls

As a telehealth provider that extends care from hospital to home, Array ensures that follow-up care is consistent and accessible.

"With Array as a partner to hospitals, when we discharge a patient home, we remain available to support their ongoing mental health needs," said Dr. Alter. "Having accessible touchpoints for behavioral care can make a significant difference in long-term outcomes."

A Commitment to Suicide Prevention

By implementing the Zero Suicide Model, Array is committed to closing critical gaps in suicide prevention and delivering the least restrictive, most appropriate care based on each patient’s specific risk level. Our comprehensive approach spans all care settings – hospital, outpatient clinic, and home – striving to prevent suicides across the healthcare continuum.

If you or someone you know is experiencing thoughts of suicide, please call or text the Suicide and Crisis Lifeline at 988 or visit 988lifeline.org and click on the chat button.