• Zero Suicide © Organizational Self Assessment

    Automated for ease of use
  • Date of Survey Submission:
     - -
  • What type of commitment has leadership made to reduce suicide and provide safer suicide care?

  • Screening

  • Do you have a written agency protocol specific to this component of suicide care?
  • Is this component embedded in your electronic health record or easily identifiable in your written documentation?
  • Do you provide staff training specific to this component of suicide care?

  • Assessment

  • Do you have a written agency protocol specific to this component of suicide care?
  • Is this component embedded in your electronic health record or easily identifiable in your written documentation?
  • Do you provide staff training specific to this component of suicide care?

  • Lethal Means Restriction

  • Do you have a written agency protocol specific to this component of suicide care?
  • Is this component embedded in your electronic health record or easily identifiable in your written documentation?
  • Do you provide staff training specific to this component of suicide care?

  • Safety Planning

  • Do you have a written agency protocol specific to this component of suicide care?
  • Is this component embedded in your electronic health record or easily identifiable in your written documentation?
  • Do you provide staff training specific to this component of suicide care?

  • Suicide Care Management Plan

  • Do you have a written agency protocol specific to this component of suicide care?
  • Is this component embedded in your electronic health record or easily identifiable in your written documentation?
  • Do you provide staff training specific to this component of suicide care?

  • Create a Leadership-Driven, Safety-Oriented Culture

  • What type of formal commitment has leadership made through staffing to reduce suicide and provide safer suicide care?
  • What is the role of suicide attempt and loss survivors in the organization's design, implementation, and improvement of suicide care policies and activities?

  • Develop a Competent, Confident, and Caring Workforce

  • How does the organization formally assess staff on their perception of their confidence, skills, and perceived support to care for individuals at risk for suicide?
  • What basic training on identifying people at risk for suicide or providing suicide care has been provided to NON-CLINICAL staff?
  • What advanced training on identifying people at risk for suicide, suicide assessment, risk formulation, and ongoing management has been provided to CLINICAL staff?

  • Systematically Identify and Assess Suicide Risk

  • What are the organization's policies for screening for suicide risk?
  • How does the organization screen for suicide risk in the people it serves?
  • How does the organization assess suicide risk among those who screened positive?

  • Ensure Every Person has a Suicide Care Management Plan (Pathway to Care)

  • Which best describes the organization's approach to caring for and tracking people at risk for suicide?

  • Collaborative Safety Planning

  • What is the organization's approach to collaborative safety planning when an individual is at risk for suicide?
  • Please indicate whether or not the organization uses the Stanley/Brown safety plan template:

  • Collaborative Restriction of Access to Lethal Means

  • What is the organization's approach to lethal means reduction?

  • Use Effective, Evidence-Based Treatments that Directly Target Suicidal Thoughts and Behaviors

  • What is the organization's approach to treatment of suicidal thoughts and behaviors?

  • Provide Continuous Contact and Support

  • What is the organization's approach to engaging hard-to-reach individuals or those who are at risk and don't show for appointments?
  • What is the organization's approach to following up on patients who have recently been discharged from acute care settings (e.g., emergency departments, inpatient psychiatric hospitals)?

  • Apply a Data-Driven Quality Improvement Approach

  • What is the organization's approach to reviewing deaths for those enrolled in care?
  • What is the organization's approach to measuring suicide deaths?
  • What is the organization's approach to quality improvement activities related to suicide prevention?
  • Should be Empty: