When the Commission first met in 2014, one clear theme emerged: successful suicide prevention in Colorado will only be achieved with comprehensive and sustained efforts across community groups and agencies; no one group or single intervention is sufficient. This priority has structured how the Office of Suicide Prevention approaches suicide prevention. Suicide can be prevented upstream, by creating the community conditions that encourage everyone to feel that their life has meaning. Suicide can be prevented during a crisis by creating mental-health services that are accessible and relevant to people across Colorado and by putting safety measures into place that make it less likely for a suicide attempt to be fatal. Lastly, suicide can be prevented by making sure that we meaningfully support individuals after a suicide attempt and after a suicide loss. Although this may sound counter-intuitive, providing caring and supportive services and resources for people mourning a loss to suicide as well as people who have survived a suicide attempt is, itself, upstream suicide prevention by making sure that people after a crisis can still feel that their lives have meaning.
Since 2014, the Commission has created recommendations that strengthen and flesh out this comprehensive approach, with strategies to prevent suicide upstream, as an intervention to a suicidal crisis, and after a suicide loss or attempt (also called postvention). These recommendations, in turn, have changed the programs and operations of the Office of Suicide Prevention, and the way that suicide prevention is carried out statewide. Please check out the Office of Suicide Prevention’s latest Annual Report for even more information on what we’ve accomplished!
|Recommendation||What’s been done|
|Support training for mental health and substance use providers.||
The Office of Suicide Prevention offers free or reduced-cost evidence-based training protocols on suicide prevention to healthcare providers that help increase provider competence in and knowledge of different aspects of clinical suicide prevention best practices.
|Develop and implement comprehensive suicide prevention strategies for priority industries.||
The Office of Suicide Prevention has partnered with other agencies and organizations to support mental health and well-being resources that meet the needs of individuals in priority industries.
For example, the Office of Suicide Prevention is a founding partner of Mantherapy.org, for working-aged men, and has funded the expansion of outreach and resources especially those in priority industries such as emergency responders, construction, agriculture and ranching, and military/veterans. The Office has also funded the build-out of OperationVeteranStrong.com, for Colorado veterans and their families.
|Support schools and other youth-serving organizations in implementing comprehensive protocols and evidence-based programming focused on enhancing protective factors.||
The Office of Suicide Prevention supports youth suicide prevention efforts with schools and youth-serving organizations across the state. OSP provides funding for training, policy development and implementation, and school climate efforts; provides technical assistance; and facilitates community connection to suicide prevention initiatives.
|Increase the prevalence of community-level programs supporting connectedness and positive social norms.||In line with the comprehensive suicide prevention approach utilized by the Office of Suicide Prevention, the Colorado National Collaborative (CNC) project has identified connectedness as one of its pillars of community suicide prevention, empowering county-level work to promote people’s sense of belonging within their communities. By implementing connectedness strategies, communities aim to increase protective factors (e.g., increased sense of belonging) that can reduce isolation, loneliness, suicide attempts & deaths.|
|Create supportive, inclusive, and safe communities, especially for LGBTQIA2S+ youth, young adults 18-24, and especially for Black, Indigenous, and Youth of Color.||
The Office of Suicide Prevention instituted decision-making procedures that center equity and created equity-specific deliverables in OSP grants and programs. For example, our funding and programs can now be used to support Gender-Sexuality Alliances (or GSA clubs) in schools, which have been shown to lower the risk of suicide for all students. These recommendations also helped build support in the Commission for the passage of the Equity Commitment, which further promotes equity-based suicide prevention as a Commission goal.
|Strengthen equitable economic stability and support, including food security, affordable housing, livable wage, and other family-friendly workplace policies, as well as access to representative care and Broadband Internet access.||In line with the comprehensive suicide prevention approach utilized by the Office of Suicide Prevention, the Colorado National Collaborative (CNC) initiative has identified economic stability as one of its pillars of community suicide prevention, empowering county-level work in housing stability, food security, and promoting working conditions that enable everyone to thrive. Strategies within this pillar involve engagement and collaboration with non-traditional suicide prevention partners, like food banks, housing stability organizations, and homelessness prevention organizations.|
|Support spiritual communities in implementing comprehensive strategies and evidence-based or evidence-informed programming that are relevant for their communities in preventing suicide; identifying and referring individuals in suicidal crises to appropriate supports; and providing appropriate postvention resources, supports, and messaging following a suicidal crisis, suicide attempt, and death by suicide.||
Creation of the Spiritual Communities Suicide Prevention Resource List and webpage, a living community-made compilation of general, religious, and faith-specific suicide prevention programs and resources at the upstream prevention, intervention, and postvention stages of comprehensive suicide prevention.
|Support the legal community with gatekeeper training to identify those at risk for suicide and link them to care.||The legal system represents another opportunity outside of the health care system to reach individuals at risk for suicide. OSP created and distributed the Suicide Prevention Benchcard, a resource for judges and other partners in the legal community (e.g., attorneys, and probation departments) that facilitates connections with evidence-based suicide prevention tips and resources.|
|Older adult-specific gatekeeper training be available, accessible, and inclusive for peers, community members, and workplaces that support and serve older adults.||The Office of Suicide Prevention is working with partners to identify opportunities to identify and expand older adult-specific training in alignment with this Commission recommendation. More information on state training can be found on the Colorado Office of Suicide Prevention Training webpage.|
|Identify shared risk and protective factors that impact youth and young adults who experience both suicidal despair and disordered eating & address disparities impacting youth populations that experience higher rates of suicidal despair and disordered eating.||The Office of Suicide Prevention is committed to addressing the intersection between disordered eating and suicide. In 2023, SB23-014 established the Disordered Eating Prevention Program in the Colorado Department of Public Health and Environment. The Office of Suicide Prevention is in active conversation with the burgeoning program about strategic alignment and future collaboration.|
|Recommendation||What’s been done|
|Adopt the Zero Suicide (ZS) model within healthcare systems||
Through the Office of Suicide Prevention, Colorado began supporting the implementation of the Zero Suicide Model in 2017. In 2019, OSP hired a full-time staff member to coordinate this initiative, whose work includes offering monthly collaborative discussions and trainings for healthcare administrators and providers to learn more about Zero Suicide and to troubleshoot challenges.
The Health Quality Incentive Program (HQIP) has expanded ZS to more hospital settings, and is an effort by the state Medicaid office to improve health outcomes by tying enhanced Medicaid incentive payments to key performance measures like ZS implementation.
|Promote screening to identify suicide risk within healthcare settings||The Zero Suicide initiative asks health systems to screen every new client or patient for suicidal thoughts and behaviors. Universal screening is a practice encouraged by the Office of Suicide Prevention among its ZS grantees and other health system partners, as screening is the first step in formulating a plan for safer suicide care for patients in Colorado.|
|Support primary care practices in adopting suicide prevention protocols||Created by the Office of Suicide Prevention and its partners, the Suicide Prevention Toolkit for Colorado Primary Care Practices is a comprehensive resource that guides primary care practices through planning and implementing key components of safer suicide care. The toolkit focuses on identification, risk assessment, safety planning, lethal means counseling, and follow-up care. OSP offers free or reduced cost evidence-based training protocols on suicide prevention to healthcare providers.|
|Prioritize, promote, and expand community-based alternatives to involuntary treatment for support, respite, and recovery prior, during, and after periods of crisis that preserve dignity and are responsive to identity, culture, and personal autonomy.||
The Office of Suicide Prevention will be piloting brief Cognitive Behavioral Therapy (BCBT) and Crisis Response Planning Training (CRP) with behavioral health providers in 2022, to give these providers additional tools and alternative interventions to reduce resorting to involuntary treatment. OSP will utilize feedback from pilot participants to identify the next best steps in supporting this goal. The OSP has also provided education to primary care providers about Colorado’s involuntary treatment laws, and emphasizes to all partners that involuntary treatment should be a last resort.
|Recommendation||What’s been done|
|Recommendation to convene a public Postvention workgroup to identify gaps in services and needs for suicide attempt survivors, suicide loss survivors, individuals supporting a person who is suicidal, and communities impacted by a suicide loss.||
The Postvention Workgroup was formed in February 2022 and is now meeting. If you are interested in participating in this workgroup, please sign up for the Interest list for Commission's Postvention Workgroup.
|Fill data gaps and enhance data collection tools and sources in Colorado.||The Office of Suicide Prevention, in partnership with the Office of Vital Statistics, transitioned data from the Colorado Violent Death Reporting System to an interactive data dashboard, providing a more useable interface to inform prevention efforts at both the local and state level.|
|Encourage and incentivize coroners, medical examiners, and law enforcement to adopt a standardized suicide investigation form||The Office of Suicide Prevention has helped to create a new Suicide Death Investigation Form, which helps collect data that may be useful in preventing suicides in the future. To help coroners and medical examiners to understand and use this form, the Office also offers annual mini-grant opportunities that incentivize offices across the state to adopt this system.|
|All schools in Colorado implement a full spectrum prevention programming starting with comprehensive protocols to address prevention, intervention, and postvention.||
Schools may leverage House Bill 2006-1098, which allows teachers and other designated staff to take suicide prevention training to fulfill continuing education requirements.
|Adopt standardized protocols for following up with suicidal patients after discharge from emergency departments, and adopt the Colorado Follow-Up Project as standard protocol for following up with suicidal patients after discharge from emergency departments and inpatient settings.||
Following the Commission’s guidance , the Office of Suicide Prevention worked collaboratively to develop and pilot follow-up services to patients post-discharge delivered utilizing the Colorado Crisis & Support Hotline. This pilot program became the Follow-Up Project.
Following the success of the pilot program of the Follow-Up Project, the Commission recommended that this program be implemented statewide. The Office of Suicide Prevention received SAMHSA funding in 2020 to fund a full-time coordinator for this initiative, and in January 2022, the Follow-Up Project had more than doubled the number of sites enrolled in the past calendar year.