Children's Wisconsin is a participant in the Preventing Youth Suicide Collaborative, a national initiative of leading children’s hospitals committed to advancing the implementation of the Zero Suicide Framework. This important work is made possible through the generous support of the Cardinal Health Foundation, in partnership with the Children’s Hospital Association.
Organization Profile
Children’s Wisconsin is a leading independent pediatric health system headquartered in Milwaukee, with a second hospital in Neenah and more than 20 community clinics across the state. The organization operates a 306-bed Level I pediatric trauma center and provides comprehensive services including acute inpatient care, over 70 specialty clinics, behavioral health, dental, and primary care. Mental health services are a growing focus and include walk-in clinics, integrated therapists in primary and urgent care, and community-based treatment for children and teens. These efforts have been supported by significant philanthropic investment. Children’s Wisconsin also partners with the Medical College of Wisconsin for pediatric training, research, and innovation.
Implementation of Zero Suicide
Children’s Wisconsin first piloted suicide screening in the emergency department in 2018, with the goal of expanding to universal screening across the health system by 2023. Early efforts revealed that screening alone was not enough—greater resources and system-wide strategies were needed to move beyond identification and ensure continuity of care for high-risk patients.
This direction was reinforced by findings from their Zero Suicide Organizational Study, which highlighted gaps in consistent screening, delivery of evidence-based suicide prevention treatment, and data-driven approaches to monitoring outcomes. Building on those findings, Children’s Wisconsin took several key steps:
- Strengthened suicide screening compliance across the system by using the Ask Suicide-Screening Questions (ASQ) as the universal screening tool and the Columbia Suicide Severity Rating Scale (C-SSRS) for follow-up risk assessments.
- Launched a text-based caring contacts program to support continuity of care for high-risk patients following urgent visits.
- Trained more than 25 providers in the Collaborative Assessment and Management of Suicidality (CAMS) to expand access to suicide-specific interventions.
- Partnered with the Wisconsin Department of Health Services to link patient data to statewide mortality records, enabling the first chart-based psychological autopsies to identify gaps in screening, assessment, and treatment.
Key Outcomes
Children’s Wisconsin has already documented measurable improvements in suicide prevention practices:
- Screening Compliance: Suicide screening completion rose from 50.9% in Q4 2023 to 74.6% in Q3 2025, demonstrating steady system-wide improvement.
- Caring Contacts Program: Launched in 2024 at the urgent mental health walk-in clinic, the program successfully connected high-risk patients to follow-up within an average of 2.38 days. Quality improvement data showed a 10.5% ED return rate, lower than the 13% typically seen in the literature, and importantly, no suicide deaths within six months among the 300 patients served. Text-based contacts were designed to support continuity of care after urgent visits, though no specific family feedback has yet been collected.
- Evidence-Based Training: Over 25 providers had been trained in CAMS across multiple clinics and care settings, helping to standardize suicide-focused treatment options.
- Data Review: In 2025, Children’s Wisconsin and the state Department of Health Services conducted a first-of-its-kind data review linking patients seen at the health system with statewide mortality records. This work allowed the organization to begin chart-based psychological autopsies, providing critical insight into care gaps for patients who had died by suicide.
Future Steps
Children’s Wisconsin will continue strengthening suicide prevention by prioritizing quality reviews of safety planning documentation and lethal means counseling. The organization also intends to expand its leadership team to include individuals with lived experience of suicidality. Recruiting families for this role has been challenging due to HIPAA considerations and concerns about potential dual relationships with families currently or potentially engaged in care. To address this, Children’s Wisconsin is working with its hospital foundation to identify families who have expressed an interest in sharing their stories in a way that maintains appropriate boundaries.
Additional plans include ongoing training in CAMS and Counseling on Access to Lethal Means (CALM) and developing workflows to support continuity of care during transitions, particularly following discharge from urgent mental health clinics and emergency departments.
By combining universal screening tools (ASQ and C-SSRS), evidence-based treatments, innovative caring contacts, and partnerships for statewide data analysis, Children’s Wisconsin is advancing a comprehensive Zero Suicide approach that ensures safer care and better outcomes for children and families across the state.