A Health Care Model to Reach Zero Suicides

A policy adopted in Eugene’s 4J School District has been creating safe spaces for transgender students from kindergarten through high school. Gender-inclusive programs at the University of Oregon have marked the school as a national leader in LGBTQ acceptance.

Assertive community treatment teams working through outreach-centered programs in Maricopa County have become an industry standard for treating those with persistent and severe mental illnesses who have recently been incarcerated. They provide a long-term approach, aiming to halt a cycle of incarceration and hospitalization by focusing on underlying issues such as what caused the police interaction and incarceration.

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

Connecting LGTBQ+ teens with peers and adults for support can help reduce depression and the risk of suicide. Organizations like the Four Corners Rainbow Youth Center in Durango, Colorado, and the Gender and Sexuality Resource Center at Fort Lewis College provide safe spaces where youth feel welcome and supported by a network of peers and adults. The centers also act as social spaces where youth, parents, and their communities can come together.

Based out of the city of Addis Ababa in Ethiopia, a live radio show is tackling the stigma around mental health care by combining their platform with those in the mental health care field. Not only does the radio show discuss psychological issues on air, but it also offers free and reduced-cost mental health services to those that serve as guests on the show.

Medical professionals throughout the United States are starting to implement mental health screenings during routine care in order to better assess those at risk of suicide. Using a combination of health records and questionnaires to flag which patients should have continued follow-ups, clinics and primary care specialists prioritization of suicide intervention is already showing significant results.

More than 2,700 police departments in the U.S. have crisis intervention teams aimed at responding to mental health crises with fewer arrests and less violence, but the death of Daniel Prude in Rochester police custody offers clear lessons in the shortcomings and misuse of the CIT model. A lack of adequate mental health services across the country, coupled with superficial training of the police, too often means a police response to a crisis will not de-escalate the situation or lead to meaningful help for the person in crisis. A recent study found CITs have not shown they will lower violence.

Seven teen suicides in one county over a two-year span prompted residents whose lives were touched by suicide to form DeFeet, an educational and advocacy group devoted to the message that suicide is preventable. Thanks in part to its trainings, public speakers, support groups, public education campaigns, and advocacy for gun safety, local schools now screen all students for suicide risk starting in middle school. A local health clinic now screens all patients and credits DeFeet, named for its annual 5K memorial walk, with creating "an environment where we are not as afraid to talk about suicide."

CAHOOTS has become a national model because of its uncommon partnership with the Eugene Police Department. The police chief says CAHOOTS' unarmed first responders to mental health crises can de-escalate crises before crimes occur or someone gets hurt. That's the idea behind the decades-old agency that takes calls where police can sometimes cause worse outcomes. The crisis intervention workers and medics treat people on the scene or transport them to places where they can get the help they need. Police are available but rarely needed for safety on those calls.

Thunder Bay police formed IMPACT (Integrated Mobile Police Assessment Crisis Team), pairing crisis responders with mental health expertise with police officers to respond 24/7 to people experiencing mental health crises. Instead of defaulting to police responses, which risk the use of force and often land people in custody or a hospital, the teams often are able to get people connected to needed social and health services. So far the team has managed to divert about 40 percent of calls to helping services.