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Judges as Champions for Suicide Prevention

by Judge Ginger Lerner-Wren�� September 12, 2018

��In April 2016, I had the pleasure of speaking at the ���������� 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. 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 , “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 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 , ‘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.

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