Intentional Work Planning Strengthens Suicide Prevention Technical Assistance

Technical assistance (TA) plays a critical role in helping health systems and organizations translate suicide prevention interventions into everyday practice. When TA is intentional, adaptive, and grounded in a shared understanding of priorities, it can effectively offer organizations a mechanism to strengthen their implementation processes and progress. This emphasis on structured implementation approaches is reflected across the suicide prevention field. 

For example, national technical assistance guidance outlined in CDC’s Suicide Prevention Technical Package highlight work planning as a key strategy for translating evidence-based interventions into practice. In this context, work planning refers to a structured, collaborative process for identifying priorities, setting shared goals, and tracking technical assistance activities over time. Furthermore, implementation research emphasizes that work planning as a technical assistance strategy can proactively strengthens organizational readiness and helps promote conditions for effective implementation.

Through the RTI Zero Suicide Initiative Coordinating Center (ZSICC), our team has learned that structured work planning is an important technical assistance approach that can serve as a catalyst for more responsive and impactful suicide prevention support. 

The Zero Suicide Initiative Grantees 

Zero Suicide Initiative grantees work towards preventing deaths by suicide by adopting seven core elements of the Zero Suicide framework—Lead, Train, Identify, Engage, Treat, Transition, and Improve. Each element has a unique role in implementation, and together they offer a comprehensive, culturally-informed strategy for transforming health systems so that suicide becomes a rare event for individuals under care. 

The Zero Suicide Initiative Coordinating Center

In 2023, the Indian Health Service began funding two  Zero Suicide Initiative Coordinating Centers. These ZSICCs are tasked with providing technical assistance, training and capacity building for the eight 2022 cohort Zero Suicide Initiative grantees, which comprise of Tribally owned health facilities and Urban Indian health care centers. Through the years, a wide range of training and technical assistance resources and tools have been shared with these ZSI grantees. Some of them can be accessed on ZSICC.com. This body of work reflects a broader field-wide understanding that intentional planning and implementation support are critical to sustaining suicide prevention efforts.  Also, the RTI ZSICC leads a cross-site evaluation that helps identify key impacts and lessons learned from implementing the model in diverse care settings.

The challenge: complexity without clarity

ZSI grantees operate in complex environments. Many grantees are integrated health systems balancing primary care, behavioral health, substance use treatment, and community partnerships while responding to urgent suicide prevention needs. Without a clear roadmap, technical assistance can become reactive, addressing immediate issues without advancing longer-term system change and implementation progress-oriented goals. Implementation research in suicide prevention has similarly found that organizations often struggle to operationalize evidence-based strategies without clear planning structures to guide sequencing, roles, and timelines.

Specifically, the RTI ZSICC team observed that even highly motivated teams needed support to track their implementation progress, align TA activities with implementation milestones, and clearly articulate where additional support was needed. These challenges risk slowing momentum and diluting the impact of evidence-based suicide prevention strategies.

Work planning is a core RTI ZSICC TA strategy

At the RTI ZSICC, we use a structured, quarterly TA planning process using a customized TA plan that serves as a shared roadmap between TA providers and grantees. Although work plan templates are commonly used in suicide prevention initiatives, including within the broader Zero Suicide community (Education Development Center, n.d.), our approach intentionally differs by engaging grantee leadership in a work plan co-creation process. Each TA plan documents priority goals, outlines specific objectives using a SMART framework, and tracks activities over time. Also, the co-created TA plans center on grantee-identified needs and implementation realities. 

Importantly, these TA plans are living documents, reviewed regularly during monthly check-ins and adjusted as conditions change. At the same time, these plans provide grantees with a structure to support accountability and learning. For example, one grantee identified a priority goal of increasing support from first responders after experiencing inconsistent response during psychiatric emergencies. Through the TA planning process, this goal was translated into concrete objectives and activities, including establishing points of contact within the police behavioral health unit. Progress on these activities was tracked during monthly check-ins, allowing the team to document outreach attempts, identify barriers such as staff turnover, and adapt next steps, such as expanding the focus beyond law enforcement to include firefighters and paramedics.

What we have learned: planning improves focus, equity, and trust

Work planning has strengthened TA delivery in several ways. First, it improves focus. By jointly identifying three to five priority ZSI-focused implementation objectives per quarter, grantees and TA providers can direct energy toward the changes most likely to advance grantees’ objectives and foster improvements in overall suicide prevention capacity. Again, this aligns with broader suicide prevention implementation literature that identifies structured planning as a mechanism for improving consistency and follow-through. In practice, this focus enabled one grantee to move from a broadly defined concern about inconsistent crisis response to a clearly scoped set of actions aimed at strengthening coordination with first responders. By narrowing the work to specific objectives, such as identifying police behavioral health contacts and initiating relationships with firefighters and paramedics, the team was able to make steady, trackable progress rather than responding reactively to each crisis.

Second, TA work planning supports shared decision-making and leadership growth among grantees. The TA objectives help grantees focus on workforce needs, community context, and service gaps, particularly in Tribal and underserved settings where long-standing gaps in care access have negatively shaped communities’ experiences. For example, leadership used the work planning process to reflect on real-time crisis experiences and determine when existing law enforcement partnerships were insufficient, prompting a strategic decision to broaden engagement to additional first responder groups.

Finally, intentional planning builds trust. When expectations, timelines, and roles are transparent, TA becomes a partnership rather than a transaction. 

Moving forward

Suicide prevention requires sustained, systems-level change. As the RTI ZSICC continues to support grantees, we see work planning not as an administrative task, but as a practical tool for learning, alignment, and impact. By grounding technical assistance in intentional planning, our team is able to support health systems in delivering timely, coordinated, and compassionate suicide care.