1125: Colorado’s Upstream Approach to Suicide Prevention

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Wednesday, May 13, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials. May is Mental Health Awareness Month, and today we explore how Colorado is rethinking suicide prevention and shifting from crisis response to upstream intervention. 

Conlin Bass, health systems suicide prevention manager for the Colorado Office of Suicide Prevention, explains Colorado's comprehensive data-driven strategy focused on reaching people before they hit a breaking point. 

CONLIN BASS:

Colorado's priorities right now are centered on a comprehensive and upstream approach. So what we're doing as part of that approach is working with organizations all across Colorado who are all doing amazing things to address suicidal despair before somebody reaches a crisis point, but also connecting people with support if they're at that point too. In practice, that means we're working with communities on fostering connectedness, economic stability, education and awareness, access to safer suicide care, postvention support for families and communities after a loss or an attempt, lethal means safety initiatives, and making sure that all of those areas are also supported by the folks that we're working with across the state. As part of that approach, we also use county-level and statewide data to identify people in communities who may be more or less likely to be feeling suicidal despair, so we know how to tailor programs to support them best. The data shows that some groups are more impacted by suicide and suicidality, such as youth, working-age men, older adults, LGBTQ plus communities, veterans, rural residents, people working in some industries like construction, agricultural, or emergency response, and people of color, such as Black, American Indian, or Alaska Native, and other groups. 

SHEEHAN:

And you mentioned more of this upstream approach, getting to people before it turns into crisis. What are some of your strategies for accomplishing that? 

BASS:

Yeah, so with partners across the state, we work really hard to address causes that lead people to feel hopeless or isolated in the first place. So, we really work on efforts that strengthen intentional person-to-person connections with family, friends, neighbors, working to expand peer support with people who have been there, so to speak, improving access to trusted adults for

youth, because we know how protective that can be for a young person to have somebody in their life that they can go to for support, supporting economic stability initiatives to support access to housing, food security, livable wages, and family-friendly workplace policies, knowing that all of these things can help somebody's mental health and support people before they reach that crisis point. A key partner are schools across the state and school-based prevention. So we prioritize programs like Sources of Strength, which is funded across dozens of Colorado schools to build resilience, belonging, and access to that really important support for students across the state. 

SHEEHAN:

Other programs include things like Mental Health First Aid, which can be part of prevention efforts. How is Colorado using that kind of training to build capacity? 

BASS:

Yeah, Mental Health First Aid, a gatekeeper or formerly gatekeeper, community helper training, helps people identify risk factors and warning signs associated with suicide and know how to respond. And when a friend or family member or neighbor or anybody in your community is struggling, it can just be so tough to know what to say, what will be supportive in that moment, and connect somebody to the support that they need. So trainings like Mental Health First Aid or other community helper trainings are one of our best prevention strategies just because it helps folks know how to recognize those warning signs and respond supportively. And doing that across the community and all of our partnerships across the state just builds a really strong safety net that no matter who you're talking to, you hopefully are gonna connect with somebody who has that skillset to be able to respond supportively. So through our partnerships with local grantees and community members across the state, in just the last year, we supported training for thousands of Coloradans. And these are teachers, employers, parents, coaches, first responders, your neighbor, just to start supportive conversations and connect somebody to help. And when a higher level of support is warranted, we've been working really hard to train clinicians in suicide prevention focused models like CAMS or Collaborative Assessment and Management of Suicidality and other evidence-based approaches that we know are effective at meeting people when they need that level of support. 

SHEEHAN:

Wow. And Colorado has one of the longest standing offices of suicide prevention. I'm wondering, how did that come about? And what kinds of investments were made early to sort of let that office sustain itself? 

BASS:

Yeah, totally. In large part, I'd say the existing infrastructure is because of leaders in the community and people who care really deeply about suicide, often those who have been touched personally by a suicide loss or attempt of themself or a loved one, working towards that infrastructure for suicide prevention at the county and at the state level. And then our Office of Suicide Prevention, we're so grateful to have one in Colorado to serve as a connector between all of those community leaders and groups doing amazing work in this space. I'd say another key strategy has been diversifying our funding sources, understanding that suicide is connected to so many other issues that our communities can face. And that's led to some pretty innovative partnerships across sectors and public health initiatives. Like we work very closely with our state overdose prevention team, knowing that those causes and issues are linked. And we've also invested in advisory and accountability groups, like our Suicide Prevention Commission, which brings together leaders in these different industries to talk about suicide prevention specifically and understand where can we work together to best support our community's mental health. 

SHEEHAN:

Wow, you've mentioned a lot of examples of sort of community leaders, partners across Colorado, like schools and health systems. That's a really wide ranging network. How do you keep all your partners sort of aligned and rowing in the same direction? 

BASS:

Yeah, good question. Well, we know that suicide is a community issue. And because of that, it really does require all hands on deck to be able to address. So we work with those partners in different spaces, whether it's healthcare or those higher risk industries or schools, for example, to align on our efforts and make sure that we're not duplicating. Hey, do you have a resource that we could offer this group or a training that you could come provide to this group of providers, things like that. We host monthly meetings for all the health systems in Colorado that are working to improve their suicide care pathways. And we partner with community organizations in those areas who support training, do outreach, provide peer support, show up in community to create resources that are guided by people with lived experience of suicide. And then we have a couple programs that I feel speak to this kind of cross sector collaboration. One of those is the Colorado National Collaborative. And that's an initiative where local communities receive funding from our Office of Suicide Prevention and the CDC to implement that comprehensive upstream framework and creates a common language and common goal across people working in very different spaces. So that's been super effective to kind of build that cross sector collaboration. So really working across diverse groups that are touched by suicide and making sure that we're all working together, ensuring resources and information where we can. 

SHEEHAN:

Wow. And to add on another group that's sort of central to the whole program, health systems. Colorado has a zero suicide initiative within health systems. How does that work? And what kind of impacts have you seen? 

BASS:

There's actually a bill in Colorado that was passed in 2014, I believe that asked health systems across the state to adopt the zero suicide framework. And with that support in the legislature and through our Office of Suicide Prevention, our office has received zero suicide grants from the federal government to fund some safer suicide care implementation efforts and eight health systems across the state. And that's where that monthly meeting with health systems come in, where the health systems can gather to hear from experts and share best practices when it comes to suicide prevention, really leveraging that lived experience of what it feels like to be in a health system and feel suicidal or have a history of an attempt or a loss. 

We've also partnered with the Colorado Department of Healthcare Policy and Financing on what's called the Hospital Quality Incentive Payment Program. HQIP is the acronym. And this partnership has offered participating hospitals Medicaid incentive dollars for implementing components of the Zero Suicide framework. So it's really helped hospitals step into this framework, improve their ability to screen for and assess for suicide risk, connect patients to the appropriate treatment and focus on those warm handoffs and care transitions that helps make sure that nobody falls through the cracks. 

And last year, over 60 hospitals participated in the program. So that was super exciting to see. We also support the Colorado Follow-Up Project. 

And that is a program that our office supports in coordination with the University of Colorado School of Medicine. And really what it does, it's a simple but high impact program where people who have discharged from an emergency department or inpatient psych unit after a suicide attempt or crisis are connected with a peer who's been there who can check in and say, hey, how are you doing? And just kind of serve as that peer support, that warm connection in a really vulnerable time. 

And in the last year we saw that 5,000 people received that caring contact after being discharged which is really encouraging to see. 

SHEEHAN:

Wow, and that all really exemplifies sort of not just the diversification of funding that you mentioned, but also that sharing of resources and that alignment within your network. That's really impressive. 

BASS:

Thank you. Yeah, it is really exciting. 

SHEEHAN:

Conlin Bass, thanks so much. 

BASS:

Thank you so much. Also just wanted to add a shout out to the amazing community members across the state that are really pouring their heart and soul and time into this work and driving it at the local level that allows us to see the impact that we're seeing. 

So just wanted to share that too. 

SHEEHAN:

Conlin Bass is health systems suicide prevention manager for the Colorado Office of Suicide Prevention.

Effective communication is not just about messaging. It depends on strong systems, resourcing, and coordination behind the scenes. As health departments face increasing demands to demonstrate impact, communicate value, and navigate complex environments, communications stands as a foundational public health capability. Join ASTHO on May 21 for an introduction to the Public Health Communications Collaborative's newly published, "Overcoming Challenges and Leveraging Strengths Action Guide for Communicators at Public Health Agencies," which outlines evidence-based strategies for organizing and operating effective public health communications functions. The registration link is in the show notes. 

What if the biggest barrier to better public health is buried in outdated policies? Austin Public Health faced that challenge, an overloaded, hard-to-navigate system that slowed staff down and made it harder to do their jobs. With support from the Public Health Infrastructure Grant and hands-on technical assistance, they set out to fix it. Find the link to the article, "Leveraging PHIG to Advance Policy Infrastructure at Austin Public Health," in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.