Why We Support the Zero Suicide Model

The Tompkins County Legislature passed a resolution a year ago to support the Zero Suicide Model, calling on local healthcare and behavioral healthcare providers to follow the model’s systematic clinical approach to preventing suicides.

image1
Members of the Cayuga Health Partners Care Coordination Team

Cayuga Health Partners, a Physician-Hospital Organization comprising more than 40 medical practices and 200 physicians and a leader of healthcare delivery in Tompkins County, pledged to become a “Zero Suicide Champion” with the goal of implementing the suicide prevention model in our local healthcare network.

That pledge was made during a June 2018 meeting of the Tompkins County Suicide Prevention Coalition, formed in 2017 by more than 30 community-based organizations. Others announcing their commitment included Cayuga Medical Center, Tompkins County Mental Health Services, Alcohol & Drug Council of Tompkins County, Suicide Prevention & Crisis Service, Cornell Health of Cornell University, and Family & Children’s Service of Ithaca.

The Zero Suicide Model involves a foundational belief that suicide deaths for those engaged in the healthcare system are preventable. It is clear that safer suicide care is in the best interest of our patient population. I know for myself and my team, we all want to go to bed at night knowing we’ve done everything in our power to support the well being of the communities we serve.

The case for Zero Suicide is compelling. The New York State Office of Mental Health has released data showing that an overwhelming number of those who die by suicide are often already engaged in health systems. More than 80 percent of people who die by suicide have had health care visits in the prior 12 months—often more recently than that. These findings are consistent with national data.

Making the commitment to become a Zero Suicide Champion was the easy part. Now, utilizing the specific strategies and tools available free of charge to practices and providers nationwide through the Zero Suicide framework, Cayuga Health Partners is working to prevent suicides while improving the care for those who seek help.

Cayuga Health Partners is working in collaboration with Ithaca’s Suicide Prevention and Crisis Service in an effort to encourage individual practices and providers to embrace the Zero Suicide Model. In the fall of 2018, we launched a series of Lunch & Learn events featuring presentations about the model by SPCS Executive Director Lee-Ellen Marvin. To date, more than 60 percent of the primary care practices in the network have opened their doors to the presentations and discussions about the role they can play in suicide prevention. Members of Cayuga Health Partners have also played a role in supporting our partner organization, Cayuga Medical Center, in its own implementation of the Zero Suicide Model.

Cayuga Health Partners (formerly called Cayuga Area Plan/Preferred) is a partnership of the Cayuga Area Physicians Alliance (CAPA) and Cayuga Medical Center. Our network mission is to unify member organizations in the pursuit of high quality, accessible, and cost-effective healthcare for the population of patients we serve. In efforts to accomplish this, Cayuga Health Partners is a physician-led, physician-driven effort combining evidence-based best practices and innovative data collection technology in a way that aligns physician incentives and community partnerships to drive improvement in clinical quality.

For more information about the Zero Suicide Model, go to: http://zerosuicide.sprc.org/

—By Emily Mallar

Emily Mallar is the director of Care Management at Cayuga Health Partners

Launching Cornell’s Comprehensive Review of Student Mental Health

In the six years that I’ve been at Cornell University, we have seen an unprecedented growth in the need for campus mental health services. While the Cornell administration has been extremely generous in increasing our clinical resources in recent years, it remains a challenge to keep pace with the growing need for care. And we’re not alone: universities across the country are struggling with similar challenges.

hogan2

Michael Hogan, leader of External Review Team

Beginning in 2018, I was part of many campus conversations—with students, colleagues, and campus leaders, including President Martha E. Pollack and Vice President Ryan Lombardi—about the need to find new ways to engage our community in addressing the environmental factors contributing to student distress, and to seek new perspectives on the services and resources available to students on campus.

In September 2018, these conversations and others led President Pollack to commit the university to a Comprehensive Review of Student Mental Health, to begin in 2019.

The Campus Health Executive Committee (CHEC) oversaw the development of the review’s scope and planning during the Fall 2018 semester. Feedback was solicited from a wide range of student, staff, and faculty stakeholders, including members of the university-wide Coalition on Mental Health. The consensus was that the comprehensive review should focus on two themes: how to meet the growing clinical needs of students facing mental health problems, and how to improve the campus environment and culture to better support student mental health.

In Spring 2019, CHEC announced the members of the two groups charged with conducting the review: an internal university Mental Health Review Committee tasked with examining Cornell’s academic and social environment, climate, and culture related to mental health, and an External Review Team responsible for reviewing the university’s clinical services and campus-based strategies.

The internal committee, made up of 13 students, faculty, and staff, is led by Marla Love, senior associate dean of students in the Office of the Dean of Students, and Miranda Swanson, associate dean for Student Services in the College of Engineering.  Love and Swanson are seasoned student affairs professionals who are relatively new to Cornell, bringing a fresh perspective to the review process. Love joined Cornell in October 2017 after serving for 15 years at various institutions across the country including Scripps College and Phillips (Andover) Academy, and most recently at Azusa Pacific University. Swanson came to Cornell in December 2017 from the University of Chicago, where she spent 16 years as dean of students in the Physical Sciences Division and working with graduate students in the Humanities Division.

Members of the internal team include Catherine Thrasher-Carroll, mental health promotion program director for Cornell Health’s Skorton Center for Health Initiatives; among the four students in the group is Chelsea Kiely ‘20, of the College of Arts and Sciences, who is president of Cornell Minds Matter, a student mental health promotion organization.

The External Review Team, comprised of three highly respected leaders in the field of mental health, is led by Michael Hogan, who served as mental health commissioner in New York, Connecticut, and Ohio over a span of 25 years. He is a member of the National Action Alliance for Suicide Prevention’s executive committee, and was a developer of the Zero Suicide Model for healthcare. Hogan chaired President George W. Bush’s New Freedom Commission on Mental Health and has served on the board of the Joint Commission, an independent organization that accredits healthcare organizations and programs in the United States.

The other members of the external team are Karen Singleton, associate medical director and chief of Mental Health and Counseling Services at the Massachusetts Institute of Technology’s MIT Medical; and Henry Chung, senior medical director of Behavioral Health Integration Strategy at the Care Management Organization of Montefiore Health System, and professor of psychiatry at the Albert Einstein College of Medicine.

Listening tours and focus groups will be held through the Fall 2019 semester, and the final report of findings and recommendations will be submitted in Spring 2020. Updates about the reviewers’ process and progress—in addition to the final report—will be posted on the Mental Health Review website.

I have also asked the members of both review teams to provide ongoing feedback to Cornell’s leadership as the review proceeds, including recommendations specific to our work at Cornell Health.

It is important for the Cornell community to note that we will not be waiting for the completion of the review to begin implementing important changes to our clinical services. A new counseling appointment model—which will include brief same-day appointments, and more options for follow-up care—will begin in Fall 2019. We look forward to the opportunity to gain valuable feedback and to identify opportunities for improvement.

I am grateful to President Pollack and Vice President Lombardi for prioritizing this university-wide review in support of student campus health. And I am confident that the review will result in a healthier and more supportive campus environment with improved support resources and clinical services for our students.

—By Kent Bullis

Kent Bullis, MD, is the executive director of Cornell Health

Photo credit: Suicide Prevention Resource Center (video screenshot)