Date of Award


Document Type

Doctoral Research Paper

Degree Name


Organizational Unit

Graduate School of Professional Psychology

First Advisor

Gwen Vogel Mitchell

Second Advisor

Jessica D. Bartley

Third Advisor

Sally Spencer-Thomas


Zero suicide model, Chronic suicide, Community mental health center


In 2018, Suicide was the 10th leading cause of death in the United States (Center for Disease Control and Prevention, 2019), and the American suicide rate continues to rise (Hedegaard, Curtin, & Warner, 2018). The lack of impact in reducing the suicide rate highlights the need to further understand how to help suicidal individuals. Nearly one third of suicides are preceded in the previous year by a visit to a mental health physician (Luoma, Martin, and Person, 2002). This paper proposes a tractable and research-validated strategy for Community Mental Health Centers (CMHCs) to appreciably reduce the suicide rate among their clients. The strategy is based upon the Zero Suicide (ZS) Model, and gives actionable steps for leadership in CMHCs to make actionable change. The core elements in this strategy include: create a holistic and rigorously implemented strategy that engages all CMHC staff and clients; move from a clinician-responsibility to a team-responsibility model for suicide prevention; regularly evaluate clients for their suicide risk, and in particular tailor interventions differently for chronic and acute suicide risks; create and maintain suitable training for all staff; explicitly engage clients in the suicide prevention effort; when needed, use pharmaceuticals that have been demonstrated to reduce risk, and encourage clients to comply with their drug regimens; and given the regrettably large gaps in research-validated knowledge on how to prevent suicide, maintain a working document, and continue to upgrade the strategy as new research comes to hand.

Copyright Statement / License for Reuse

Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Statement

Copyright held by the author. User is responsible for all copyright compliance.


37 pgs