Suicide Prevention

Suicide is a leading cause of preventable death in the United States, affecting individuals and families across all ages and backgrounds. Many people who experience suicidal thoughts or behaviors visit their primary care or behavioral health provider in the months before a crisis. This makes early detection, compassionate assessment, and coordinated follow-up essential steps in saving lives.

As part of our commitment to improving whole-person health, WellSense supports providers in using evidence-based suicide prevention tools and practices across care settings. These approaches are grounded in the nationally recognized Zero Suicide framework and guided by the latest research and clinical best practices.

The Zero Suicide framework

The Zero Suicide model is a systemwide approach designed to make suicide prevention a core responsibility of healthcare. It promotes a culture of safety, accountability, and continuous improvement. The seven key elements of the framework include:

  1. Lead: Leadership commitment to suicide prevention as a core organizational priority.
  2. Train: Ensure all staff are trained to identify and respond to suicide risk.
  3. Identify: Screen every patient for suicide risk using evidence-based tools.
  4. Engage: Build trust and collaborate on immediate safety plans when risk is identified.
  5. Treat: Use proven, evidence-based interventions for individuals at risk.
  6. Transition: Support safe transitions between care settings, ensuring no one “falls through the cracks.”
  7. Improve: Use data and feedback to refine and strengthen suicide prevention efforts over time.

For health plans and provider organizations, adopting these principles ensures every member of the care team plays a role in recognizing and addressing suicide risk with compassion and consistency.

Evidence-Based Assessment Tools

Columbia-Suicide Severity Rating Scale
(C-SSRS)

The C-SSRS is a widely used, evidence-based screening tool that helps clinicians assess suicidal ideation and behavior. It provides clear questions to evaluate the severity of suicidal thoughts, past attempts, and current risk. The tool’s structured approach supports better decision-making and helps guide next steps for care.

  • Purpose: Identify whether a patient is thinking about suicide and to what extent.
  • Use in Practice: The C-SSRS can be used in primary care, behavioral health, or emergency settings as part of routine assessments.
Brief Suicide Safety Assessment
(BSSA)

For individuals who screen positive for suicide risk but are not in immediate crisis, the BSSA helps clinicians conduct a brief, structured conversation to determine the level of risk, protective factors, and next steps.

  • Purpose: Guide safe and appropriate care decisions after a positive screen.
  • Use in Practice: The BSSA supports collaborative safety planning, lethal-means counseling, and timely follow-up care to keep patients safe.

How providers can help

  • Screen routinely: Ask about suicidal thoughts as part of regular health visits.
  • Assess carefully: Use structured tools like the C-SSRS and BSSA to guide clinical decisions.
  • Plan collaboratively: Work with patients to develop personalized safety plans.
  • Follow up: Ensure timely contact after a crisis or emergency visit.
  • Train continuously: Participate in ongoing education on suicide prevention and response.

By integrating these practices into everyday care, providers can make a measurable difference in reducing suicide risk and improving patient outcomes.

  1. American Academy of Pediatrics. (2023, November 17). Conducting a brief suicide safety assessment. In Blueprint for youth suicide prevention: Strategies for clinical settings.

  2. American Psychiatric Association. (n.d.). Suicide and suicide prevention — Practice resources and clinical guidelines.

  3. Columbia Lighthouse Project / Columbia University Department of Psychiatry. (n.d.). About the Columbia-Suicide Severity Rating Scale (C-SSRS).

  4. National Institute of Mental Health. (n.d.). Ask Suicide-Screening Questions (ASQ) toolkit: Brief Suicide Safety Assessment (BSSA). 

  5. Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. The American Journal of Psychiatry, 168(12), 1266–1277.

  6. Zero Suicide Institute. (n.d.). Zero Suicide resources and implementation tools.