Best practices for the introduction and integration of suicide prevention in emergency departments: Enhancing readiness and capacity for action and change

Background/Purpose: In the State of Hawai‘i, suicide is the single leading cause of fatal injuries among Hawai‘i residents ages 15 to 74. Trauma centers and emergency departments (EDs) are often the first stop for individuals who are suicidal or attempt suicide, and thus are well-situated to offer prevention and intervention services to them and their families. The aim of the “Enhancing the Statewide Trauma Network” project is to develop community networks of healthcare providers and community members who share the same knowledge and language related to suicide prevention. Methods: “Communities that Care (CTC)” is one framework which helps to increase readiness and capacity for the implementation of evidence-based interventions. An adapted version of the CTC framework was applied to EDs enrolled in the project (10 current, 13 forthcoming). Assets and gaps were noted, and individualized implementation plans were established for each site. Results: The most important elements to establish readiness were leadership support, multiple champions at the site, prioritization of suicide prevention as an issue, and connections with resources and collaborators outside of the ED. Just as in communities, establishing and maintaining these elements has been challenging and time-consuming. Discussion/Conclusions: Just as in communities, the issues of readiness and capacity building need to be addressed in healthcare settings when starting any intervention. This study demonstrates an innovative application of a readiness framework in conjunction with an evidence-based suicide prevention program. While conducting this process with EDs can be challenging, systematic and coordinated efforts can result in more sustainable organizational changes.