Last month I attended the Zero Suicide Global Summit in Liverpool, England with 110 global attendees from 22 countries and all continents (except Antarctica). The event is part of an international movement to transform healthcare systems and to aspire to “zero suicides.” Since its inception, the Zero Suicide Summit has traveled the globe. Past Summits have been held in:
Oxford 2014
Atlanta 2015
Sydney 2017
Rotterdam 2018
Liverpool 2024
I’ve had the privilege of attending the summits in 2017, 2018, and this latest one. Each event builds on the last, driving forward our collective mission to reduce suicides to zero.
Why Was this Zero Suicide Global Summit Special?
In addition to the perseverance of six years of planning due to pandemic complications and other issues, this year’s summit was particularly special to me for three reasons.
Community: First, it was a great opportunity to reconnect with international friends and colleagues including three United Suicide Survivors International board members, who all had speaking roles – Dr. Ursula Whiteside, Chris Wojnar, and myself.
Lived Experience Focus: Our involvement underscores the second reason this Summit is special – the partners leading the Zero Suicide international efforts are acknowledging the importance of including people with lived and living experience in Zero Suicide discussions. These voices keep us connected to the true meaning behind Zero Suicide, offering vital insights into why certain processes and practices may or may not be effective, and challenging some of the entrenched norms within healthcare systems.
Attention to the Wellbeing of the Healthcare WorkforceFinally, for the first time I know of — thanks to the leadership of Julie Goldstein Grumet, the Summit explored the topic of healthcare workers’ mental health and suicide risk in Zero Suicide Implementation.
Our international panel on "Considering Workforce Wellness in Zero Suicide Implementation” emphasized the critical importance of supporting the healthcare workforce, who already face elevated risks. The H.O.P.E. Certification was offered as a protective strategy and possibly even a foundational pre-requisite for implementing Zero Suicide strategies. The work of suicide prevention can significantly impact those involved, and adhering to H.O.P.E. best practices can mean the difference between thriving in this demanding field or experiencing adverse events. By prioritizing workforce wellness, we ensure that those tasked with preventing suicide are supported and protected.
Highlights from Liverpool 2024
Welcome Message from the Prince of Wales: A touching video message that set an inspiring tone for the summit.
Panel #1 - Zero Suicide Implementation Results from the US and Australia:
Brian Ahmedani, Julie Richards, Jennifer Boggs, Sue Murray shared insightful data and outcomes from their respective regions. Julie Richards highlighted US outcomes demonstrating a significant 16% increase in safety planning and a 25% reduction in suicide attempts within 90 days of the last healthcare visit, underscoring the effectiveness of Zero Suicide practices.
Implementation Science:
Becky Stoll emphasized the importance of how we implement change, not just what we implement. She spoke about the need for readiness for change, involving co-creation with those affected, and building a supportive culture around clinical innovations.
Integration of Lived Experience
Ursula Whiteside shared profound insights on integrating lived experiences with Zero Suicide. Her approach on NowMattersNow.org helps reduce suicidal thoughts by teaching Dialectical Behavior Therapy (DBT) skills, and providing practical tools for immediate relief.
3 Dads Walking: This moving story of three fathers who lost their daughters to suicide brought a powerful message about the impact of suicide and the importance of community support. Their walks across the UK have raised significant awareness and funds for suicide prevention. The audience rose to their feet, many in tears and all filled with awe about what these Dads have done in honor of their loved ones.
Technology in Suicide Prevention
The summit also delved into the role of AI and technology in suicide prevention. Dan Joyce and Nawal Roy presented groundbreaking work on AI's potential to predict and prevent suicides, highlighting the critical role of data and technology in our future strategies. This sparked some discussion about the ethics of AI, the ability to predict suicide, and the human element of suicide prevention.
Two Favorite Presentations
1) The Past, Present, and Future of Suicide Prevention in Clinical Services
Nav Kapur, a global leader in suicide prevention, provided valuable insights into the evolution and future of suicide prevention in clinical services. He underscored the importance of involving individuals with lived experience in the process, shifting the focus from prediction to supporting clinicians through compassionate and collaborative work. Kapur emphasized that services with high staff turnover often have poorer outcomes, highlighting the need for a stable and supported workforce.
Nav also critiqued current suicide prevention screening programs for their shortcomings, particularly the lack of effective interventions for patients identified through screening. He called for a shift away from risk prediction towards addressing patient needs by focusing on modifiable factors. His presentation stressed the necessity of creating safer systems and implementing real-world quality improvements.
2) Panel on Funding and Return on Investment for Zero Suicide
A critical discussion during the panel focused on the economics of suicide prevention. The panel emphasized the importance of demonstrating the societal value and return on investment of life-saving interventions to policymakers and funders. David McDaid and Michael Schoenbaum. There was extensive discussion on the complexities and significance of addressing suicide within a financial context.
Convincing policymakers and funders to allocate resources requires demonstrating a tangible return on investment. This includes not just economic arguments but also complementary ones, showing evidence that interventions are cost-effective. However, the concept of "Return on Investment" can be misleading, as the benefits often accrue to society rather than directly to the funding entities, and we lack mechanisms for reallocating these gains.
The panel also highlighted the practice of "defensive medicine," where legal liability and fears of adverse outcomes drive decisions. The fear of being sued and losing a lawsuit often far exceeds the actual risk, leading to behavior that prioritizes avoiding litigation over addressing the true needs.
Listening to economists discuss these issues can be challenging, as moral and economic considerations sometimes lead to different conclusions. Therefore, approaching these discussions with sensitivity is crucial.
Moving Forward
Joe Rafferty, PhD, CEO of Mersey Care NHS Trust Foundation, underscored the provocative idea of “zero” in suicide prevention, exploring this captivating idea – is suicide is truly inevitable and what happens when we aspire to zero?
Claire Murdoch, National Mental Health Director, NHS, and Richard McKeon, Senior Advisor, SAMHSA, discussed national strategies and policies, emphasizing the need for a coordinated, compassionate, and holistic approach to suicide prevention.
Conclusion
This summit has been an enlightening and motivating experience. The shared knowledge, experiences, and innovations have strengthened our resolve to continue pushing for systemic and cultural changes in healthcare. We must ensure that our caregivers receive the support they need to provide the best care for their patients.
Remember, as we move forward, "You’ll Never Walk Alone." Together, we can achieve a future where no one has to suffer in silence.
