Context The World Health Organisation estimates one person dies by suicide every 40 seconds. In Australia it’s estimated around 20% of suicides are people who have been in the Australian healthcare system. This is not an acceptable outcome for modern healthcare systems.

Process The Zero Suicide Healthcare (ZSH) framework has been adopted in many developed countries, comprised of seven elements designed to build organisational capability, improve clinical practice and create better service pathways for recovery.

Analysis ZSH draws on techniques of quality management and continuous improvement. It implicitly assumes suicide prevention can be addressed in health care settings in the same way, and with the same absolute improvements, as has been done in wound management, infection control and medication management. It advances evidence-based practice in suicide prevention as a standardised and systematic reform. It encourages the use of data and measurement to monitor performance for continuous improvement within healthcare settings.

However, there is no single source of understanding of how the elements of the ZSH framework interact to achieve outcomes. The development of the Theory of Change for ZSH provides greater clarity about the overall design of the framework using program theory. This will also underpin the evaluation of ZSH across projects.

Outcomes A model will be presented demonstrating alignment to the ZSH framework and giving a consistent approach to evaluation and monitoring of implementation and supported by standardised data collection.

Learning Outcomes Increased understanding of Theory of Change as it applies to the ZSH framework.