Zero suicide and the Rotterdam Declaration

Posted 24th April 2019

This week Life in Mind is highlighting the Zero Suicide Healthcare initiative as an example of global collaboration for suicide prevention. Life in Mind aims to increase knowledge sharing and build connections between organisations and communities working in suicide prevention.

Originating in the United States, Zero Suicide Healthcare is a global approach that aims to change how society and the healthcare system look at care: from passive acceptance to active prevention.

The inspirational goal of ‘zero suicide’ provides a framework for healthcare systems to continually improve their quality of care.

Zero Suicide Healthcare recognises that health care for a person living with suicidal thoughts involves the whole healthcare system, with staff trained and supported to provide excellent suicide prevention care.

Evidence shows that many more suicides are prevented in healthcare systems which provide better suicide prevention care. According to David Covington, leader of the Zero Suicide initiative, radical system transformation can drive down suicide rates to zero. Knowing this, there is no time to lose. To make inroads we need systemic change.[1]

Using evidence-based tools, systemic practices, and training and embedded workflows, Zero Suicide seeks to address service gaps and inspire healthcare systems to continually improve their quality of care.

Thomas Priselac, CEO from Cedars-Sinai Medical Centre in Los Angeles says, “It is critically important to design for zero even when it may not be theoretically possible. When you design for zero, you surface different ideas and approaches that if you’re only designing for 90 percent may not materialize. It is about purposefully aiming for a higher level of performance.”

Within various health and behavioural care settings there are a number of opportunities to identify and provide care to those at risk of suicide. According to the Zero Suicide Healthcare approach, we can only do this by framing suicide as a core responsibility of health care.

Zero Suicide offers healthcare leaders clear strategies and principles to help them in their quest to protect even more patients, relatives and staff against the tragedy of suicide.

On September 3-4, 2018, over 100 leaders from nearly 20 countries gathered at the Zero Suicide International 4 summit in Rotterdam to design a revised version of the 2015 International Zero Suicide Declaration.

Participants representing a diverse group of healthcare leaders, academic institutions, private organisations, governments, civil society and people with lived experience formally committed to improving healthcare suicide prevention through a number of strategies


[1] Covington, D.W and Mokkenstorm, J 4th International Zero Suicide Summit, Rotterdam 2018.

Subscribe to eNews

Keep up to date and sign up to the Life in Mind eNews, sharing some of the latest news and research in suicide prevention.

Sign up now