Our Commitment to Mental Health Care with the Zero Suicide Initiative

In May 2023, Trinity Health Ann Arbor and Trinity Health Grand Rapids joined the Suicide Care Collaborative Improvement and Innovation Network (SC CoIIN), a national effort by hospitals to prevent suicide. 

The Pew Charitable Trusts and the Zero Suicide Institute started this network, helping hospitals work together to test and share ways to find suicide risk and connect patients with support. 

Research shows that nearly half of people who die by suicide have interacted with a health care system in the month before their death. That means hospitals have a powerful opportunity to make a difference.

Through SC CoIIN, participating hospitals work together to:

• Improve suicide screening
• Create personalized care plans
• Provide interventions for those at risk

The goal is simple but powerful: transform how hospitals care for people at risk of suicide.

A hospital-wide commitment

For Trinity Health Ann Arbor, the goal is to integrate behavioral health with medical care to create a more comprehensive treatment approach. Joining SC CoIIN helped structure efforts already underway to improve suicide prevention. The focus was on developing a clear process for identifying and supporting patients at risk for suicide, starting with one inpatient unit.

To lead this work, Trinity Health Ann Arbor formed a Zero Suicide Work Group with members from across the hospital. Guided by the belief that suicide deaths in health care settings are preventable, the group is laying the foundation for achieving zero suicide deaths.

At Trinity Health Grand Rapids and Trinity Health Ann Arbor, all behavioral health staff are trained in QPR (Question, Persuade, Refer). This three-step evidence-based training helps individuals – not just clinicians – feel secure in supporting someone in a suicidal crisis by questioning in a direct but nonjudgmental way, persuading them to seek help, and referring them to the appropriate resources for support. 

QPR training has had a significant impact at Trinity Health Grand Rapids:

• Knowledge of how to persuade someone to get help improved from 27% to 74.5%
• Awareness of local resources rose from 25.7% to 83.3%
• Willingness to ask about suicide increased from 89.9% to 99.4%

"Nearly half of our inpatient nurses and social workers have completed QPR training," said Casie Sultana, a clinical nurse leader at Trinity Health Grand Rapids. “This helps bring a behavioral health perspective into more areas of the hospital.”

Screening, assessment and safety planning

A key success in Ann Arbor is ensuring that patients who are screened as at risk for suicide receive full suicide risk assessments. This is made possible by adding a behavioral health specialist to the medical units, who conducts assessments, safety planning and treatment. As a result, assessment completion rates increased by more than 50%.

At both hospitals, social workers and behavioral health specialists help patients at moderate to high-risk for suicide make personalized safety plans before they are discharged home. 

These plans include:

• Triggers to watch for
• Support contacts
• Coping strategies
• Safe places to go

These plans are embedded in the patient’s records, so patients and providers can access and update them over time.

"We put a behavioral health therapist on our medical floors,” said Melissa Tolstyka, director of Behavioral Health Services at Trinity Health Ann Arbor. [BM1] “They evaluate patients who are at high risk for suicide and create safety plans, plus they assist with smooth discharges." 

“What began as a pilot program resulted in a 63 percent rise in completed safety plans,” said Tolstyka. “It also led to a 46 percent increase in full assessments within 24 hours of screening.”

Partnering with the community: be nice. program

In Grand Rapids, the hospital and Trinity Health West Michigan Medical Group have partnered with the Mental Health Foundation of West Michigan to promote the be nice. program. This upstream mental health and suicide prevention program teaches people how to act early.

The be nice. initiative encourages individuals to: 

1. Notice what’s right or different
2. Invite yourself to start a conversation
3. Challenge stigma and access resources
4. Empower yourself and others with knowledge

The program was created in 2011 to raise awareness about bullying and its impact on mental health. Today, it helps build communities that are more connected, inclusive, and kind.

Key benefits of be nice. include:

• Raising mental health awareness
• Promoting inclusion and belonging
• Increasing connectedness
• Reinforcing a positive culture
• Preventing suicide
• Creating a shared language around mental health
• Encouraging kindness

“Mental health is just as important as physical health,” said Sultana. “This program helps reduce the stigma around discussing suicide and self-harm.” 

Trinity Health Ann Arbor and Trinity Health Grand Rapids are using evidence-based practices, creating a culture of awareness and working with the community to build a future where every patient feels seen, supported and safe. Suicide prevention is not just a clinical goal; it's a shared responsibility.

Learn more about the one-year impact of the Zero Suicide Initiative at Public News Service.

If you or someone you know needs support, call 988, the Suicide and Crisis Lifeline.

Learn more about our mental health and substance abuse services.