Expanding Zero Suicide: Qualitative Assessment of Community Mental Health Center Partnerships Supporting Rural Suicide Prevention.

Rural communities in the United States have elevated suicide death rates and lower access to mental health services than more urbanized areas. Zero Suicide is a framework that promotes evidence-based suicide care for individuals at risk for suicide and is increasingly being adopted in rural healthcare and mental health provider organizations, including Community Mental Health Centers (CMHCs). Population-focused suicide prevention is more likely to be effective when mental health and healthcare providers engage with social services and other provider organizations (e.g., schools, law enforcement) in the community, however collaborations between CMHCs and other community-based organizations that can play a role in suicide prevention have not been examined. To understand these partnerships, we conducted semi-structured interviews with representatives of 12 community-serving organizations in the geographical area served by a CMHC in its seventh year of Zero Suicide implementation. Thematic content analysis was used to identify key facilitators and barriers to suicide prevention partnerships from the perspectives of the community partners. Analysis yielded three facilitating and four barrier themes related to effective partnerships with the CMHC. Despite significant barriers in areas such as sharing information and inadequate staffing of programs, CMHCs implementing Zero Suicide in rural communities can significantly impact external partners' engagement in broader suicide prevention efforts.