Origins of the zero suicide philosophy

In 2001, Henry Ford Behavioral Health in Detroit, USA, pioneered the concept of 'zero suicide' as an aspiration. They developed a care pathway to assess and modify suicide risk for patients with depression. This ground-breaking approach led to zero suicides for 18 months in 2009-2010.

In the years since Henry Ford first envisioned 'zero' as the goal, a worldwide Zero Suicide movement has emerged. Mental health organisations and governments across the globe have embraced the idea and designed a growing number of programmes intended to prevent suicide deaths. Read more about this on the Henry Ford website.

Inspired by their success, Professor Joe Rafferty CBE, Chief Executive of Mersey Care NHS Foundation Trust wanted to bring this approach to the UK and in March 2015, a zero suicide policy was launched at Mersey Care.

A zero suicide target means a commitment to eliminating suicides in our health service. The core principle is that suicide is preventable.

Preventing every death should be at the heart of caring for someone with a mental illness, just as it is for physical illnesses.

Mersey Care was one of the pioneering areas in the UK to commit to this ambition, signing up to principles such as:

  • Creating a leadership-driven, safety-oriented culture committed to dramatically reducing suicides.
  • Constructing a restorative just and learning culture where staff feel supported and empowered to speak up about safety concerns without fear of blame or retribution.
  • Systematically identifying and assessing suicide risk levels and ensuring timely care that meets individual needs.
  • Continuing support and contact once a patient is discharged.

The programme of work also included:

  • improved training for staff, focusing on the clinical skills needed to work with patients and their families to develop a ‘safety plan’ – a personalised care plan with clear ways to get help 24/7
  • working with other providers and stakeholders to share innovative practice – including CALMSamaritans and the Cheshire and Merseyside Reduction Partnership
  • establishing a dedicated Safe from Suicide team to provide advice, support, assessment and monitoring

The results from places like Detroit showed us that aiming for zero suicides inspires innovative ideas and approaches that might not emerge if we were aiming for a 5 or 10% reduction.

“Our commitment to suicide prevention extends beyond hospital care, emphasising continuous support even after a patient is discharged, to prevent them from falling back into crisis.” Joe Rafferty

Joe decided to go further and look at how the zero suicide principles could extend to wider society. During this journey, he was contacted by Steve Mallen, a father who had sadly lost his son to suicide. Together, with Elaine Darbyshire and Dr Geraldine Strathdee OBE, the Zero Suicide Alliance (ZSA) launched.

Utilising the expertise of suicide prevention clinician, Jane Boland, and the lived experience of Angela Samata, the ZSA's Suicide Awareness Training was developed. This training officially launched the ZSA at the Houses of Parliament on 16 November 2017.

Find out more about our the ZSA co-founders

The ZSA is proudly affiliated with international partners:

As a Zero Suicide International partner, the ZSA and Mersey Care support international events and other opportunities to share learning and innovation, facilitate discussions to continue support suicide awareness and prevention at a global level.

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