Suicide Prevention Pathway

From research, we know that deaths from suicide and repeat hospital presentations for suicide attempts can be reduced when a structured prevention pathway is implemented that combines best clinical practice, leadership commitment, evidence-based treatments as well as ongoing data collection and review. The Hertfordshire Suicide Prevention Pathway, developed and co-produced with experts by experience, will provide all of this and more, with a structured approach to care and smooth transitions for service users across our system.

In January, we will be piloting the Hertfordshire Suicide Prevention Pathway Pilot for our acute services including A&E at Watford General Hospital and the Lister Hospital in Stevenage .

The Suicide Prevention Pathway has the following six components:

Screening to identify service users at risk of suicide.

Assessment enhanced by introducing the Chronological Assessment of Suicide Events (CASE) approach.

Risk formulation using a prevention-oriented approach to enable broader understanding of the issues to support care planning.

Brief interventions including safety planning, counselling on restricting access to lethal means, crisis numbers, brief service user and carer information, and rapid follow up.

Structured follow up to re-assess suicidality; review the safety/ care plan; communication with carers, families, and health professionals; identification and involvement of other agencies and identification of any barriers to treatment.

Transition of care including warm handover to ongoing care.  There will be a community befriending element of the pathway, linking people to holistic support post-discharge.

As part of the implementation, all staff involved will be offered a comprehensive training programme. The efficacy of the pathway will be evaluated and monitored by the HPFT research team in collaboration with Health Innovation East.

Introducing the Chronological Assessment of Suicide Events (CASE) approach

The CASE approach training, informed by work at Gold Coast Health in Australia will be used as a part of this new pathway. We will be pioneering the use of the CASE Approach in the UK as a flexible, practical, and easily learned interview strategy for eliciting suicidal ideation, planning, and intent. We are currently identifying staff across our acute mental health services to undertake this training in the first instance.

Training Materials to Support Clinical Staff

We’ve created new resources that can be used by our clinical partners to support staff with their suicidal risk assessments. Please click the links below to download materials as needed.

A clinical framework document has also been created to provide additional detail regarding the pathway.

Suicide is a significant issue, not only does it result in the premature death of the person, but it has also wide-reaching effects on the families, friends, and communities. We know that people bereaved by suicide are themselves at increased risk. These are only some of the reasons to take a new prevention approach to suicide.

If you would like to receive more detail about the new Hertfordshire Suicide Prevention A&E Pathway Pilot, please contact Dr Rakesh Magon, Consultant Psychiatrist, Deputy Medical Director & ICS Mental Health Lead, Hertfordshire Partnership University NHS Foundation Trust at, or Dr Nisha Jayatilleke, Associate Medical Director, Hertfordshire and West Essex ICB at

Suicide Prevention Pathway PowerPoint
Suicide Prevention Pathway Clinical Toolkit updated
May 2024
Suicide Prevention Pathway Screening Tool
Suicide Prevention Pathway PORF Supplemental Documents
Suicide Prevention Pathway Brief Intervention Supplemental Documents
Suicide Prevention Pathway Follow Up Supplemental Documents