Co-worker education initiative aims to achieve Zero Suicides in an area with some of the highest suicide rates in the country.
by Jordan Larimore
ST. LOUIS - This year, more than 40,000 Mercy co-workers completed a Zero Suicide Initiative education course. It wasn’t done because of any outside demands or requirements, but because of a commitment to the dignity of every person Mercy serves.
“There are no government directives or other rules around organizations or companies doing something proactive to decrease suicides,” said Dr. Douglas Walker, an internationally renowned Mercy clinical psychologist based in New Orleans who serves in an outreach role for Mercy. “It’s not something somebody is telling us we have to do. Mercy is making zero suicides a goal because we can save lives by spotlighting behavioral health issues. It has never been more critical, with suicide deaths rising in many of our states. Behavioral health should be treated no differently than any other physical health issue. It’s a major part of a person’s overall health even though some symptoms can’t be seen visually.”
Dr. Walker, who has taught or lectured in 23 countries around the world, began the effort of establishing Mercy as a Zero Suicide Initiative organization simply by asking, “What are we doing to prevent suicide?” in a 2018 Mercy Behavioral Health Specialty Council meeting. At that point, he was assigned to create a subcommittee on the topic and set out on the aspirational goal.
That led to work with the Zero Suicide Institute, a division of the Educational Development Center, a global nonprofit that works to improve education, promote health and expand economic opportunity. Founded in 1958, the group has worked on behavioral health programs in 80 countries around the world.
Suicide rates actually dropped nationwide in 2020 after a nearly two-decade increase. While that is the most recent year for which data has been validated, many experts anticipate the 2021 rate could spike as the continued stress of the COVID-19 pandemic stretched well into the year, peaking in a deadly summer of Delta variant cases and deaths.
Despite the nationwide drop, suicide rates increased in three of the four states where Mercy primarily serves, according to the U.S. Centers for Disease Control and Prevention (CDC):
Arkansas – +5.7%
Kansas – +1.4%
Missouri – +0%
Oklahoma – +6.4%
All four states were within the 15 highest suicide rates in the country, and the overall rate among them is nearly 36% higher than the national average, according to the same CDC data. Nationwide, suicide was the second-leading cause of death in 2020 in people ages 10-14 and 25-34. Given those alarming numbers, Mercy is refocusing efforts on prevention with both patient care and education for co-workers.
Kirsten Sierra is Mercy’s Zero Suicide coordinator and chairs the suicide subcommittee Dr. Walker founded. Her position is based in Mercy’s quality and safety department, where suicide prevention is thought of no differently than infection prevention or other patient safety measures.
With patients, the challenge is making sure they’re prepared once they leave Mercy’s care, because suicide risk is volatile and suicidal thoughts can be invasive.
“We want people to know what to do and what to watch for when they leave our facilities,” Sierra said. “When you screen someone, you’re screening them at one point in time. Suicide risk fluctuates, often rapidly. So with a plan in hand, people are prepared and not caught off guard when their mood rollercoasters or hits a low. First, we show them how to help themselves, and second, how to reach out for help if things go off the tracks and they are in crisis again. We give them an action plan they can put in motion on their own. It gives them some sense of independence to know what to do.”
Clinicians in other specialties often discuss their own symptoms to their peers in casual conversation, such as a cardiologist asking an orthopedic specialist about a sore shoulder or knee. Never, though, Dr. Walker said, do colleagues ask him about their mental health upon finding out that he’s a psychologist.
“There is a stigma attached to it,” he said. “It’s very unfortunate that as a society we believe a broken heart is different than a broken arm. And maybe it’s because you can’t see it, at least most of the time. I’ve got stuff that I deal with, my family’s got stuff, we’ve all got our stuff that we deal with, and somehow we think that we’re lesser for it, but I can tell you, I’ve met some of the strongest people I’ve ever met right here in my office.”
If you or someone you know needs support now, call or text 988. Or go here for additional resources and video on mental health.
Mercy, one of the 25 largest U.S. health systems and named the top large system in the U.S. for excellent patient experience by NRC Health, serves millions annually with nationally recognized quality care and one of the nation’s largest Accountable Care Organizations. Mercy is a highly integrated, multi-state health care system including more than 40 acute care, managed and specialty (heart, children’s, orthopedic and rehab) hospitals, convenient and urgent care locations, imaging centers and pharmacies. Mercy has 900 physician practices and outpatient facilities, 4,000 Mercy Clinic physicians and advanced practitioners, and more than 40,000 co-workers serving patients and families across Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas.