Mental Health and Specialist Services, Gold Coast Hospital and Health Service, Southport, QLD, Australia.
Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia.
Aust N Z J Psychiatry. 2021 Mar;55(3):241-253. doi: 10.1177/0004867420971698. Epub 2020 Nov 16.
The Zero Suicide Framework, a systems approach to suicide prevention within a health service, is being implemented across a number of states in Australia, and internationally, although there is limited published evidence for its effectiveness. This paper aims to provide a description of the implementation process within a large health service in Australia and describes some of the outcomes to date and learnings from this process.
Gold Coast Mental Health and Specialist Services has undertaken an implementation of the Zero Suicide Framework commencing in late 2015, aiming for high fidelity to the seven key elements. This paper describes the practical steps undertaken by the service, the new practices embedded, emphasis on supporting staff following the principles of restorative just culture and the development of an evaluation framework to support a continuous quality improvement approach.
Improvements have been demonstrated in terms of processes implementation, enhanced staff skills and confidence, positive cultural change and innovations in areas such as the use of machine learning for identification of suicide presentations. A change to 'business as usual' has benefited thousands of consumers since the implementation of a Suicide Prevention Pathway in late 2016 and achieved reductions in rates of repeated suicide attempts and deaths by suicide in Gold Coast Mental Health and Specialist Services consumers.
An all-of-service, systems approach to suicide prevention with a strong focus on cultural shifts and aspirational goals can be successfully implemented within a mental health service with only modest additional resources when supported by engaged leadership across the organisation. A continuous quality improvement approach is vital in the relentless pursuit of zero suicides in healthcare.
零自杀框架是一种针对卫生服务机构的自杀预防系统方法，目前正在澳大利亚和国际上的多个州实施，尽管其有效性的证据有限。本文旨在描述澳大利亚一家大型卫生服务机构实施该框架的过程，并介绍迄今为止的一些结果和从该过程中获得的经验教训。
黄金海岸心理健康和专科服务机构于 2015 年底开始实施零自杀框架，旨在高度忠实于七个关键要素。本文描述了该服务机构所采取的实际步骤、嵌入的新实践、强调在恢复性公正文化原则下支持员工以及开发评估框架以支持持续质量改进方法。
在实施流程、增强员工技能和信心、积极的文化变革以及在机器学习用于识别自杀表现等领域的创新方面，都取得了显著的改进。自 2016 年底实施预防自杀途径以来，“常规业务”发生了变化，使成千上万的消费者受益，并降低了黄金海岸心理健康和专科服务消费者中重复自杀企图和自杀死亡的比率。
通过全服务、系统方法进行自杀预防，并强烈关注文化转变和理想目标，可以在心理健康服务机构中成功实施，只需适度增加资源，并得到组织内各级领导的积极参与。持续质量改进方法是在医疗保健中追求零自杀的关键。
