A #ZeroSuicide World: Interview with David W. Covington, LPC, MBA

[Episode 106] Today's episode of the Social Work Podcast is about a healthcare initiative called Zero Suicide.  In today�s episode, I spoke with David W. Covington, LPC, MBA who, along with Mike Hogan, developed the Zero Suicide initiative. We talked about how he went from clinician to health care executive, from running a crisis service to organizing Zero Suicide initiatives around the world. We talked about what Zero Suicide means for providers and health care leaders and ended with information about how you can get your healthcare organization involved in Zero Suicide.

• Zero Suicide: http://zerosuicide.sprc.org
• David's website  https://davidwcovington.com/
• Twitter
• David W. Covington: https://twitter.com/davidwcovington
• #ZeroSuicide: https://twitter.com/zerosuicide_org 
• Zero Suicide Intitute: https://twitter.com/ZSInstitute

Download MP3 [54:49]


So why should social workers care about Zero Suicide?

• Zero Suicide fits social work values. Zero suicide can only happen in a culture where people are encouraged to reach for the moon � that is no suicide, but are not punished for falling short. This idea of a �just culture� comes from Henry Ford Health System�s �Perfect Depression Care.� 
• Zero Suicide can�t happen without social workers. Social workers provide more mental health services than all other professions combined. Social workers are team players and Zero Suicide is inherently interprofessional. 
• Social workers are advocates. What if health care organizations use best practices, but those best practices haven�t been developed with diverse racial and ethnic groups, or don�t into account complex medical or trauma histories? What if Zero Suicide means that health care organizations have to spend more on training and staffing? Who will advocate for consumers if those costs are passed along to consumers rather than investors? Social workers have a professional responsibility to be involved in those conversations.   
• Social workers are trained to identify and respond to issues at the practice � the micro, and policy � the macro � level. Well guess what � ZeroSuicide is like the holy grail of micro-macro integration: it requires coordinated changes in values, beliefs, and practices at the provider- and system-level. David will talk more about this during the interview, but in plain English it means that as a social worker I have to believe that suicide is preventable, know how to assess, intervene, and coordinate care, and trust that my organization will have my back. At a systems level, health care organizations have to make a multi-year commitment of time and resources to reduce suicide deaths, train and support clinical and non-clinical staff, screen and assess everyone in the system, and use data-driven quality improvement.  It can�t work without changes at the micro and macro level.

Bio 

David and I giving the #ZeroSuicide sign at 2016
American Association of Suicidology Conference.

Transcript
Introduction 

Hey there podcast listener, Jonathan here. In today�s episode of the Social Work Podcast you and I are going to tackle the question �can healthcare make suicide a �never event?� Are their things that health care systems and the people who work in those systems like social workers, counselors, nurses, doctors, psychologists� you know the list� Are there things that can be done so that suicides don�t happen? I hear what you�re thinking� �sure we can do better, but some suicides are inevitable. I mean, at the end of the day, if someone really wants to kill themself, they�ll do it.� And that�s what I was taught. But just hold on to that thought for a while � we�ll come back to it.
Ok, so why should health care tackle the issue of suicide head on? Here are some stats: According to the World Health Organization over 800,000 people die to suicide every year. In the USA, suicide is the second leading cause of death among Americans ages 10 � 34. It used to be homicide. But now it is suicide. That�s right - during the healthiest years of life, Americans are more likely to kill themselves than be killed by someone else. So wait. That�s the answer, right? Healthy people don�t go to the doctor, so the healthcare system can�t tackle this issue. Yes and no. Yes, if we want to reduce global suicide deaths from 800,000 per year to zero we�ll have to tackle more than just health care systems. In the US there are many groups of people who don�t trust health care providers. African Americans are more likely to turn to religious leaders than health care professionals, in part because they�ve been abused and neglected by the health care industry for hundreds of years. People who have migrated to the US can�t get what they need because of language barriers and different definitions of what constitutes a problem. White people living in rural areas might not have language or cultural or historical barriers, but life in small communities can make confidentiality more difficult. When it comes to suicide, for all groups, the struggle with shame and silence is real.
But any effort to reduce suicide has to include health care systems. People across the lifespan see health care providers and people across the lifespan die by suicide.  A 2015 study by Ahmedani and colleagues looked at suicide attempts in US health care systems (Ahmedani et al., 2015). They found that nearly 65% of people who made a suicide attempt had seen their doctor within a month, and nearly 40% saw their doctor the week before they tried to kill themselves. So, what would need to change in health care so that those 65% were identified, appropriate care was provided, and the suicide attempt was prevented? As my guest David Covington explains, there would need to be changes at the individual provider and systemic levels. And the first change is that individual providers and health care systems would need to believe that suicides are preventable. In other words, they would all need to agree on the goal of Zero Suicide.

So why should social workers care about Zero Suicide?

• Zero Suicide fits social work values. Zero suicide can only happen in a culture where people are encouraged to reach for the moon � that is no suicide, but are not punished for falling short. This idea of a �just culture� comes from Henry Ford Health System�s �Perfect Depression Care.� 
• Zero Suicide can�t happen without social workers. Social workers provide more mental health services than all other professions combined. Social workers are team players and Zero Suicide is inherently interprofessional. 
• Social workers are advocates. What if health care organizations use best practices, but those best practices haven�t been developed with diverse racial and ethnic groups, or don�t into account complex medical or trauma histories? What if Zero Suicide means that health care organizations have to spend more on training and staffing? Who will advocate for consumers if those costs are passed along to consumers rather than investors? Social workers have a professional responsibility to be involved in those conversations.   
• Social workers are trained to identify and respond to issues at the practice � the micro, and policy � the macro � level. Well guess what � ZeroSuicide is like the holy grail of micro-macro integration: it requires coordinated changes in values, beliefs, and practices at the provider- and system-level. David will talk more about this during the interview, but in plain English it means that as a social worker I have to believe that suicide is preventable, know how to assess, intervene, and coordinate care, and trust that my organization will have my back. At a systems level, health care organizations have to make a multi-year commitment of time and resources to reduce suicide deaths, train and support clinical and non-clinical staff, screen and assess everyone in the system, and use data-driven quality improvement.  It can�t work without changes at the micro and macro level.

In today�s episode, I spoke with David W. Covington, LPC, MBA who, along with Mike Hogan, developed the Zero Suicide initiative. We talked about how he went from clinician to health care executive, from running a crisis service to organizing Zero Suicide initiatives around the world. We talked about what Zero Suicide means for providers and health care leaders and ended with information about how you can get your healthcare organization involved in Zero Suicide.
But, before we get into it, I�d like to ask you three things � and no, I�m not asking for money. First, I know there are tens of thousands of people who listen to the podcast, but I don�t know much about you. I would be so grateful if you took a minute to fill out an audience survey. You can find the survey link in the �info� section of this episode, and on the top right corner of the Social Work Podcast website. Second, if you like what you hear, please leave a review on iTunes. The more reviews, the easier it is for folks to find the podcast. Finally, I�ve had several requests for transcripts. I�d love to be able to provide transcripts for every episode. Many are, but some aren�t. So, if you have an interest in transcribing an episode in exchange for an shout out in the next episode, send me email.
And now, without further ado, on to episode 106 of the Social Work Podcast: A #ZeroSuicide World: Interview with David W. Covington, LPC, MBA

But, before we get into it, I�d like to ask you three things � and no, I�m not asking for money. First, please take a minute to fill out the Audience Survey: http://survey.podtrac.com/start-survey.aspx?pubid=Iqglf8oKcaQi&ver=standard. I know there are tens of thousands of people who listen to the podcast, but I don�t know much about you. You can find the survey link in the �info� section of this episode, and on the top right of the Social Work Podcast website. Second, if you like what you hear, please leave a review on iTunes. It helps folks find the podcast. Finally, I�ve had several requests for transcripts. I�d love to be able to provide transcripts for every episode. So, if you have an interest in transcribing an episode, send email. Ok, that wasn�t so bad was it?

And now, without further ado, on to episode 106 of the Social Work Podcast: A #ZeroSuicide World: Interview with David W. Covington, LPC, MBA

Interview 
(forthcoming)

References and resources

• Ahmedani, B. K., Stewart, C., Simon, G. E., Lynch, F., Lu, C. Y., Waitzfelder, B. E., � Williams, K. (2015). Racial/Ethnic differences in health care visits made before suicide attempt across the United States. Medical Care, 53, 430�435. http://doi.org/10.1097/MLR.0000000000000335
• Zero Suicide: http://zerosuicide.sprc.org
• David's website  https://davidwcovington.com/
• Zero Suicide: An International Declaration for Better Healthcare (2015) http://www.slideshare.net/davidwcovington/zero-suicide-international-declaration-draft-01-september-2015
• David's research publications: https://davidwcovington.com/research-papers/
• Twitter
• David W. Covington: https://twitter.com/davidwcovington
• #ZeroSuicide: https://twitter.com/zerosuicide_org 
• Zero Suicide Intitute: https://twitter.com/ZSInstitute

 

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APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2016, September 4). #106 - A #ZeroSuicide World: Interview with David W. Covington, LPC, MBA [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2016/09/zerosuicide.html