Suicides and attempts fall in health systems implementing the 'Zero Suicide Model,' study finds

Health care systems can reduce suicides through patient screening, safety planning and mental health counseling, a new study suggests, an important finding as the U.S. confronts it 11th leading cause of death.

The “Zero Suicide Model” was developed in 2001 at Detroit-based Henry Ford Health, where the focus on people considering suicide included collaborating with patients to reduce their access to lethal means such as firearms and then following up with treatment.

The approach made a difference, and for all of 2009, the health system saw no suicides among patients. The researchers then studied what happened when a different health system, Kaiser Permanente, adopted the program in four locations from 2012 through 2019.

Suicides and suicide attempts fell in three of the locations, while the fourth maintained a low rate of suicides and attempts. Suicide attempts were tracked in electronic health records and insurance claims data. Suicides were measured using government death records.

Reductions varied and reached up to 25%, said lead author Brian Ahmedani, of Henry Ford Health.

“Over the course of the year, that’s up to 165 to 170 suicide attempts that were prevented at these participating health care systems,” Ahmedani said.

The study, published Monday in JAMA Network Open, shows the model works, said Katherine Keyes, a Columbia University public health professor who studies suicide.

Prior research has shown that nearly everyone who dies by suicide is seen by a health care provider in the year before their death, Keyes said. Many doctor's offices have started asking patients whether they've thought about harming themselves.

“We are coming into contact with people who are at high risk for suicide. If we don’t ask them, we don’t know,” said Keyes who was not involved in the new study.

Grants from the National Institute of Mental Health funded the research.

“Complex health problems like suicide cannot be challenged effectively without federal leadership,” said Mike Hogan, who led mental health systems in Connecticut, Ohio and New York, and chaired President George W. Bush’s commission on mental health in 2002 and 2003.

“This is a very important research report, confirming that reducing suicide among people in health systems is possible,” Hogan said.

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