Zero Suicide: A Comprehensive Framework for Pediatric Hospitals

Zero Suicide: A Comprehensive Framework for Pediatric Hospitals 1024 683 Mary Bates, PhD
Sad black teenage girl

Key elements of the program include leadership support, practical tools and training for staff, and a quality improvement infrastructure.

Suicide is the second leading cause of death among 10- to 24-year-olds, and the number of youths presenting to pediatric hospitals for suicide-related concerns has doubled in recent years.

Suicide is more than just a mental health problem, it’s a social justice and public health issue, says Meredith Chapman, MD, the medical director of the Center for Suicide Prevention and Research at Nationwide Children’s.

At a presentation at the recent annual meeting of the American Academy of Child and Adolescent Psychiatry, Dr. Chapman described the implementation and expansion of Zero Suicide at Nationwide Children’s.

Zero Suicide is a comprehensive, system-wide approach for health care organizations — including a specific set of tools and strategies — to suicide prevention and intervention.

One of the fundamental ideas of the program is that suicide prevention is not just the responsibility of an individual provider or the behavioral health department, it is an organizational responsibility.

“It takes leadership and vision,” says Dr. Chapman, who is also an associate professor of psychiatry at The Ohio State University College of Medicine. “Everyone needs to see suicide prevention as part of their role and part of the mission of their organization. It requires that everyone buy in and appreciate that this is an issue that affects us all.”

As part of the program, health care professionals commit to help patients navigate the complex landscape of health and mental health care. Another key element of Zero Suicide is the use of standardized, evidence-based tools to identify and assess suicide risk and then to intervene, as well as training so health care professionals are competent and confident in implementing these tools.

In addition, Dr. Chapman says that the program’s emphasis on tracking and using data to continuously improve efforts fit well into Nationwide Children’s existing culture of quality and safety.

Next year, Nationwide Children’s will expand their Zero Suicide work to other pediatric practices around Ohio.

“We will work with other children’s hospitals in Ohio to better track real-time data related to suicide attempts and deaths from suicide across the state,” says Dr. Chapman. “We are also working at a national level with other pediatric hospitals around the country to define the gold standard of care for suicidal youth.”

By describing how Nationwide Children’s has implemented the Zero Suicide framework, Dr. Chapman highlighted how pediatric health care systems have the ability to drive change and innovation in suicide prevention and intervention.

“We know that a lot of people who die by suicide, youths included, have contact with a health care provider before their deaths,” says Dr. Chapman. “And mostly, it’s not mental health care providers, it’s primary care doctors or emergency department visits.

“As healthcare providers, we all have the opportunity to ask directly about suicide, show people we care and intervene meaningfully.”



Chapman, MR. 2021. Journey to Best Outcomes: Zero Suicide Implementation and Expansion at Nationwide Children’s Hospital. Journal of the American Academy of Child and Adolescent Psychiatry. 60 (10): S31. Doi: 10.1016/j.jaac.2021.07.138.

About the author

Mary a freelance science writer and blogger based in Boston. Her favorite topics include biology, psychology, neuroscience, ecology, and animal behavior. She has a BA in Biology-Psychology with a minor in English from Skidmore College in Saratoga Springs, NY, and a PhD from Brown University, where she researched bat echolocation and bullfrog chorusing.