Organization Profile
Lakeshore Community Health Care (LCHC) is a federally qualified health center and patient-centered medical home serving Wisconsin communities with primary care, behavioral health, dental, and pharmacy services. In 2024, LCHC provided more than 52,000 visits to 14,000 patients, most of whom are low-income: 86% fall below 200% of the federal poverty level, and over 60% are Medicaid-enrolled
Implementation of Zero Suicide
In 2023, following pandemic-related challenges, LCHC recommitted to behavioral health integration, enhancing suicide prevention capacity across its clinics. Efforts included:
- Workforce-wide QPR (Question, Persuade, Refer) training — more than 75% of staff trained, with QPR incorporated into onboarding and biannual refreshers.
- Targeted implementation in dental clinics with Columbia Suicide Severity Rating Scale (C-SSRS) screenings.
- EHR optimizations to support adherence, along with visible patient messaging and promotion of the 988 crisis line.
- Within two months of launch, dental hygienists achieved 91% screening adherence for patients ages 11+, with expansion to all new patient appointments maintaining 87% adherence.
Response Protocol
When a patient screens positive, BH case managers (BHCMs) provide same-day or telehealth assessments, using the C-SSRS Lifetime Clinical Scale or SAFE-T. They deliver brief interventions, create safety plans using the Stanley Brown model, counsel on lethal means safety, and connect patients to further care.
Key Outcomes
- Approximately 7% of dental patients screened positive for suicide risk.
- Risk stratification showed: 1.6% low risk, 5% moderate risk, and 0.7% high risk.
- Epic reporting allowed ongoing monitoring of adherence and prevalence trends.
Next Steps
LCHC will expand suicide screening to primary medical and behavioral health visits, as well as school-based programs serving ~50 schools. Advanced workforce training is planned for Fall 2025, using the AMSR (Assessment and Management of Suicide Risk) curriculum.