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While CoSPLAY is a new program, it reflects University Health’s involve multiple partners in higher education and organizations serv-
ongoing commitment to suicide prevention. It builds on the success of ing teens and young adults, including the LGBTQ+ population that
the Zero Suicide initiative, launched in July 2019 with support from is at higher risk of suicidality. CoSPLAY aims to strengthen access and
the Substance Abuse and Mental Health Services Administration delivery of suicide care interventions, create protective environments,
(SAMHSA). and identify and support persons at risk for suicide.
Alyssa Martinez, a licensed clinical social worker with Univer- CoSPLAY partners include Our Lady of the Lake University, Uni-
sity Health’s Community Initiatives and Population Health team, versity of Texas at San Antonio, San Antonio College and organiza-
has seen how the programs can help people. “The impact of both tions like Alamo Area Teen Suicide Prevention Coalition and Fiesta
Zero Suicide and CoSPLAY have been truly life-saving,” Martinez Youth.
said. “When we educate somebody about the crisis lines, help them The CoSPLAY program is designed to establish multiple pathways
create a safety plan, or even just be an open ear willing to listen to to support young people at risk. University Health is starting with its
their story, we help them find hope to continue forward and live own clinics and will then expand to collaborate with community part-
another day.” ners, training staff to recognize warning signs and connect individuals
to resources and care. We are implementing healthcare-based inter-
Zero Suicide ventions where patients will be screened for suicide risk. Those who
University Health began implementing the Zero Suicide program screen positive will be connected to social workers trained in reducing
in July 2019 as a comprehensive suicide prevention and intervention access to lethal means. Additionally, the program will involve training
initiative. The program aims to reduce suicide attempts and fatalities, teachers to equip them with coping and problem-solving techniques,
particularly among adults, veterans and individuals with serious men- enabling them to better identify and assist individuals at high risk for
tal illness. The Zero Suicide team has also worked to raise awareness suicidal ideations. Just like Zero Suicide, the CoSPLAY team works to
about the impact of suicide in Bexar County and establish referral identify and engage patients at risk for suicide by increasing screening,
processes for individuals experiencing suicidal thoughts. Additionally, comprehensive assessment and safety planning, and ensuring the con-
the program focuses on improving care and outcomes for patients at tinuity of care for youth.
risk of suicide. Crucially, the program’s success in fostering a leader- In the past year, University Health has established referral path-
ship-driven, safety-oriented culture within University Health ensures ways and trained staff to effectively support youth with, or at risk for,
its sustainability and long-term effectiveness. Although funding from suicidal ideation. This year, we are shifting our focus to fostering inter-
our federal partner, SAMHSA, ended on September 30, 2022, we con- agency collaboration.
tinue to support the program. Program staff have an important goal: to de-stigmatize mental
In 2023, nearly 300,000 primary care appointments took place health issues and achieve a 10 percent reduction in suicides and sui-
in clinics implementing Zero Suicide. During these visits, the Patient cide attempts. They plan to accomplish this through healthcare provid-
Health Questionnaire (PHQ-3), which screens for symptoms of er training, expanding access to mental health treatment and suicide
depression, was administered in 201,210 appointments. This frequen- prevention resources, and teaching coping and problem-solving skills
cy of screening has accounted for 69 percent of all appointments. The through social-emotional learning programs.
PHQ-3 successfully identified suicide risk in patients, leading to fur- CoSPLAY is funded by the Centers for Disease Control and Pre-
ther evaluation with the more detailed PHQ-9. This helped clinicians vention and National Center for Injury Prevention and Control.
identify, diagnose, monitor and measure the severity of depression in
Suicide Prevention Resources: 552 cases, representing 0.3 percent of those screened. So far in 2024, Some Statistics to Consider:
“Deaths due to suicide and homicide, often referred to collective-
PHQ screenings have occurred for nearly 70 percent of appointments,
with 0.3 percent of patients screened showing some degree of suicide ly as violent deaths, have been a leading cause of premature death to
University Health’s Zero Suicide risk. The top three types of mental health referrals in 2023 and 2024 people aged 10–24 in the United States. A previous version of this
report with data through 2017 showed that suicide and homicide
were to 1) neurology, 2) psychiatry and 3) behavioral health. In total,
rates for people aged 10–24 were trending upward … The suicide rate
there were 17,216 referrals made for these specialties in 2023 and
and CoSPLAY Programs 13,781 in 2024 to date. Specifically for behavioral health, there were among people aged 10–24 remained stable from 2001 through 2007
5,103 referrals in 2023 and 3,179 in 2024 thus far. Our five social
and then increased 62 percent from 2007 through 2021 (from 6.8
to at least 498 patients since 2023. Two years after receiving funding,
db471.pdf
By Mercedes Ingram, PhD, LPC workers dedicated to the Zero Suicide initiative have provided care deaths per 100,000 to 11.0).” www.cdc.gov/nchs/data/databriefs/
Zero Suicide has established and reinforced a workflow that effectively
Suicide is a leading cause of death in the United States, with a sig- CoSPLAY screens, detects and refers patients at risk for suicide, saving lives —
nificant rise among young people in recent years. In 2021, it became The latest initiative, CoSPLAY (Comprehensive Suicide Preven- one patient at a time.
the second leading cause of death for individuals aged 10-24. To com- tion Blueprint for Adults and Youth), was awarded a $3.6 million,
bat this issue, University Health has proposed two innovative pro- four-year federal grant in late 2023, funded by the Centers for Disease Strong Partnerships Mercedes Ingram, PhD, LPC, is the Senior Director of the
grams and received funding to connect individuals with resources and Control and Prevention and the National Center for Injury Preven- While Zero Suicide has helped thousands of people screened Mental Wellness Initiative, Community Initiatives and
provide care for those at risk of suicidal ideation. tion and Control. through University Health care sites, CoSPLAY is expanding to Population Health at University Health.

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