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ZERO SUICIDE IN
HEALTHCARE
The Story of an International Declaration
& Social Movement
davidwcovington.com
We are
Sparta!
baseline
King
Leonidas
(Sparta)
WE CANNOT DO
THIS ALONE
EDUCATION
Building the capacity for change
knowledge exchange and training
EDUCATION
Errors Are
Costly
1986
CROSSING THE QUALITY CHASM
Better Care = Patient Experience
Safe Effective
Patient-Centered Timely
Efficient Equitable
Triple Aim of Healthcare Improvement
Better Health Better Care Better Value
1986
Don
Berwick
(USA)
Errors Are
Costly
19861986
Don
Berwick
(USA)
1996
Going to
War with
Suicide
David Litts
(USA) “[At the start] there was a lot of debate about whether or not it was even
possible to reduce suicide through this type of an effort,” according to David
Litts. “A lot of people, including mental health practitioners, were skeptical. But
over a six-year period, the suicide rate dropped by one-third.”
US Air Force Initiative
2001
What if care
were
perfect?
20012001
Ed Coffey
(USA)
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
100
80
60
40
20
0
2004
What was
actually
different?
Henry Ford Clinical Protocol
Package of Discrete Research-based Interventions
Known to Be Effective
Routine
Screening &
Assessment
Psychosocial
Treatment
Collaborative
Safety Planning
Follow-Up
2004
Justin
Coffey
(USA)
Standard
Crisis Care
2005
John Draper
(USA)
The
Clinician
Viewpoint
20092009
David
Covington
(USA)
Magellan Health Surveys
30,000 in Workforce
Lived
Expertise
Voice
2010
Eduardo
Vega
(USA)
REDESIGN
Moving beyond best practice to innovative
designs based on novel concepts
EDUCATION REDESIGN
2010
“Over the decades,
individual [mental
health] clinicians
have made heroic
efforts to save lives…
but systems of care
have done very
little.”
Forgotten
Patients
Richard
McKeon
(USA)
Gotta Have
a Model
2011
Suicide Care in Systems
Framework
Michael
Hogan
(USA)
2011
2012
Systems
Models
2012
Nav Kapur
(UK)
2013
Website &
Seven
Elements
2013
Julie
Goldstein
(USA)
Implementation
Academies
2013
Julie
Goldstein
(USA)
MOVEMENT
Unifying the industry around the common
cause of improving health care for all
EDUCATION REDESIGN MOVEMENT
2014
1st
Int’l ZS
Summit
Jerry Reed
(USA)
Oxford
2015
A Whole
Nation
Discussion
2015
Norman
Lamb, MP
(UK)
Suicide Prevention in Ontario
Hospitals
2015
2nd
Int’l ZS
Summit
Jo Smith
(UK)
SEA #56
Michael
Hogan
(USA)
2016
2017
ZERO APPLIED
Sydney
From International Declaration to
Local Action
3rd
Int’l ZS
Summit
2017
Sue Murray
(Australia)
2018
London
1st
Int’l Crisis
Summit
2018
Caroline
Dollery (UK)
2018
Rotterdam
4th
Int’l ZS
Summit
2018
Jan
Mokkenstorm
(Netherlands)
FULL SCALE
Changing mainstream practice standards
by ensuring widespread deployment
EDUCATION REDESIGN MOVEMENT FULL SCALE
2013
US News &
World
Report
2013
Becky Stoll
(USA)
2014
SUPRA-NET
Care &
Community
2014
Jan
Mokkenstorm
(Netherlands)
4th
Int’l ZS
Summit
2017
Jan
Mokkenstorm
(Netherlands)
October 2017
2015
Social
Movement
2015
Joe Rafferty
(UK)
2017
Joe Rafferty
(UK)
2016
Speed to
Market
Gold Coast Health
2016
Kathryn
Turner
(Australia)
2017
Gaining
Momentum
2017
Ian Dawe
(Canada) Suicide Prevention in Ontario
Hospitals
2018
MD & MBA
2018
Steve Duffy
(N. Zealand)
2018
NIMH 5-Year
Grant
Brian
Ahmedani
(USA)
Rotterdam 2018
JENNA HEISE
Texas, USA
JAN ULRICH
Kentucky, USA
VIRNA LITTLE
New York, USA
FRED MESERVEY
New York, USA
PAUL SCHYVE
Joint Commission,
USA
DAVID JOBES
Catholic University,
USA
KATE COMTOIS
Seattle, USA
THOMAS JOINER
Florida State
University, USA
CHRIS DAMLE
Phoenix, Arizona
GREGOR
HENDERSON
London, UK
HELEN GARNHAM
London, UK
PAUL YIP
Hong Kong, China
ADRIAN JAMES
Exeter, UK
SALLY SPENCER-
THOMAS
Denver, USA
KEVIN HINES
Atlanta, USA
URSULA WHITESIDE
Seattle, USA
davidwcovington.com

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Zero Suicide in Healthcare: The Story of an International Declaration and Social Movement