Two years ago, The Mental Health Center of Greater Manchester implemented the Zero Suicide Initiative which integrated new services, strategies, added trainings and other improvements throughout the entire agency to prevent suicide for those in our care. Zero suicide is important to every individual in the state of NH as it impacts every facet of our communities from businesses to families. The 7 pillars of the Zero Suicide approach include: Lead, Train, Identify, Engage, Treat, Transition, and Improve. At every level from scheduling protocols to service delivery, MHCGM has made changes and improvements. During the first year of implementing the Zero Suicide Initiative, 80% of our staff of nearly 450, received additional targeted training. These trainings have resulted in increased awareness of risk factors and warning signs, which inform personal interactions with clients, families, and community supports, as well as treatment decisions.

Because MHCGM provides various levels of care at multiple locations via office-based and community-based teams, suicidal risk is identified and assessed through screening, assessing, and risk formulation early and often. If suicide risk is identified, a comprehensive assessment is conducted and an action plan is developed.

While New Hampshire experienced a 6.6% increase in suicide rate from 2017 to 2018, deaths by suicide for those our agency serves decreased significantly following our first full year of Zero Suicide implementation. Further, MHCGM experienced a 44% decrease in death by suicide for people in active treatment. It is important to note that Manchester constitutes NH’s diverse urban heart and is a federally designated resettlement zone. On average, data shows Manchester experiences poorer outcomes than 500 similarly urban areas, including but not limited to, elevated poverty rates, unemployment rates, and the rate of uninsured.

Since 2016, MCHGM has offered a Mobile Crisis Response Team(MCRT) that provides 24/7 emergency response directly to the individuals affected through the deployment of mental health clinicians and peer support/recovery coaches alongside the Manchester Police Department(MPD). Since its inception, MCRT has served thousands of individuals, providing tens of thousands of services to individuals aged 5 to 96, with an average response time of 16 minutes. Currently, the MCRT program is credited with providing a 94% diversion rate away from the hospital emergency departments and to appropriate mental and behavioral health services. In addition, our work with the MPD has led to the implementation of Crisis Intervention Training (CIT), which is designed to develop and encourage the strategic communication of police officers when responding to individuals experiencing mental and behavioral health challenges, thereby lessening incidences of force and reducing risk of injury. CIT has revolutionized police and public interactions here in Manchester. Currently, MPD has approximately 75 CIT-trained officers. Anecdotally, MPD’s Patrol Sargent and MHCGM liaison recently stated to an NH expert reviewer that if MCHGM involvement with CIT and Mobile Crisis Response were to ever cease to exist, he would quit on the spot. MHCGM’s impact on the community, hospital diversions, suicide response and reduction, and overall cost savings for fire and safety is immense.

Because the targets of Zero Suicide require community investment, our Emergency Services & Interim Care Department will use its participation in the Manchester Shared Emergency Response System to influence coordinated care around suicide prevention and the creation of suicide safe environments. As an integrated behavioral health partner in our community, MHCGM has opportunities to engage other providers in Zero Suicide implementation and is committed to doing so whenever and wherever possible.

Recently, MHCGM’s Zero Suicide outcomes were chosen by the Suicide Prevention Resource Center (SPRC) – a resource for healthcare systems across the nation for Suicide Prevention – as a highlight story for others to learn from. To read the full report, click here: https://zerosuicide.sprc.org/about/research-articles-outcomes/outcome-stories