Judges as Champions for Suicide Prevention
by Judge Ginger Lerner-Wren medium.com September 12, 2018
In April 2016, I had the pleasure of speaking at the Executive Forum, New York Association of Psychiatric Rehabilitation Services, Inc. I was there to speak on Broward’s mental health court and its therapeutic approach based on human dignity and principles of recovery. As I waited, an alert came across my phone. The New York Times had just reported a 30-year high rate of deaths by suicide in America.
At that moment, I had to do more to reduce stigma surrounding suicide prevention. As soon as I returned, I affirmatively declared Broward’s mental health court, A Zero Suicide Initiative Court. Meaning that suicide prevention is now elevated as a core priority of the court.
What is Zero Suicide?
According to the National Action Alliance for Suicide Prevention, “Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems, and also a specific set of tools and strategies. As noted, it is both a concept and a practice.” Zero Suicide is a system-wide approach, which intersects with the legal system across many sectors.
Problem Solving & Unified Collaborative Family Courts
As pioneer of the first mental health court in the U.S. I am aware of the accelerated growth and popularity of court strategies which are collaborative and look to “root causes” and respond to psycho-social problems which land on the courthouse steps. Since the establishment of the first drug court in 1989, and mental health court in 1997, the integration of behavioral health as a part of the court process is well accepted. Judges and legal actors in problem-solving treatment courts, juvenile and collaborative family courts are highly educated in matters of behavioral health. This includes early childhood development, adverse childhood experiences, trauma-informed care, domestic violence and evidence-based data on what works in terms of behavioral health strategies and best practices.
Raising the Bar for Suicide Prevention
I have written several articles on the importance of judicial engagement in raising the urgency for suicide prevention in the legal system. Elements for Zero Suicide in health care delivery systems include: leadership, training, identification of risk, engagement in safety planning, effective treatment, continuity of care and improved quality of data.
From a judicial perspective, many of these same elements are relevant in terms of leadership and suicide prevention education and awareness. Examples of how I implemented a Zero Suicide Initiative in mental health court include the following:
Suicide prevention is pronounced as a court priority.
Messaging, education and breaking the silence surrounding suicide prevention by continuous messaging about suicide risk and prevention.
Every individual is provided information on suicide prevention and crisis resources, including local helplines and the national suicide prevention Lifeline.
In-court clinicians screen for suicide risk factors.
Advocacy for community-wide suicide prevention comprehensive strategies.
A New View on Risk for Suicide
According to a recent report from the CDC, ‘Nearly 45,000 Americans age 10 or older died by suicide in 2016.” Further, researchers found that “more than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death.” Problems, relating to relationships, money, jobs, physical health, family problems, housing stress and overall despair; contribute to risk for suicide. Based on this new view concerning risk of suicide, it is incumbent on all judges and legal actors take a lead for suicide prevention and help reach people outside of the traditional health care settings and champion suicide prevention.