National Suicide Prevention Week begins Sunday, September 5, and ends Saturday, September 11, coinciding with Suicide Prevention Month in September. The goal of Suicide Prevention Week and Month is to reduce bias and misinformation regarding suicide and decrease barriers to seeking help.
Suicide is a national tragedy that crosses all ages, races, genders, and socioeconomic statuses. Even someone who seems happy or “has it all” can be vulnerable to suicide.
Statistics from the Centers for Disease Control (CDC), National Institutes of Health, and National Alliance of Mental Illness rank suicide among the ten leading causes of death in the United States. Moreover, suicide rates have been rising across the country. From 1999 to 2019, the national suicide rate increased 32 percent—from 10.5 to 13.9 per 100,000.
Blog: Physician Suicide Awareness and Prevention
Multisectoral Partnership Approach
Despite the chaos of 2020, the overall national suicide rates actually decreased by 5.6%, according to the Journal of the American Medical Association. This surprising statistic gives some experts hope that prioritizing mental health through multisectoral partnerships (e.g., public health, mental health, schools, families, workplaces, and the community at large) can reduce suicide deaths and support the mental health of those at increased risk.
Here are steps each sector can take:
Primary Care Physicians (PCP)
The Suicide Prevention Resource Center (SPRC) outlines a comprehensive approach to suicide prevention that involves PCPs. It includes these key components:
- Establish protocols for screening, assessment, intervention, and referral;
- Train all staff in suicide care practices and protocols, including safety planning and lethal means counseling;
- Create agreements with specific behavioral health practices that will take referrals;
- Ensure continuity of care by transmitting patient health information to emergency care and behavioral health care providers to create seamless care transitions and follow up with at-risk patients by phone between visits;
- Provide information on the National Suicide Prevention Lifeline crisis line and services.
Those attempting suicide usually end up in the emergency department. The CDC says that 22 percent of people who died by suicide visited an ED in the four weeks before their death.
During the height of the pandemic, CDC said ED visits for suspected suicide attempts increased among adolescents aged 12–17 years, especially girls. (ED visits were 50.6 percent higher among girls aged 12–17 years than during the same period in 2019.)
This exposure gives ED providers a unique vantage point and ability to connect with other professionals.
A prior SCP Health blog post, “ED Providers: How to Assess, Manage, and Treat Suicidal Patients,” outlined in detail what ED providers can do to spot warning signs and then manage and treat suicidal patients. It contains a list of risk factors, a psychiatric suicide risk assessment plan, and steps to manage suicidal patients.
SPRC also prescribes a comprehensive approach for emergency departments, which includes:
- Conducting universal or selective screening for suicide risk;
- Providing at-risk patients with a full assessment by a mental health professional trained in effective suicide care;
- Providing brief interventions while patients are still in the ED (e.g., safety planning, lethal means counseling);
- Ensuring careful discharge planning and safe transitions of care to outpatient services.
Mental Health Community
The mental health community should focus on removing barriers that prevent people from seeking help. One of the main barriers is the stigma associated with the act. For this reason, patients often do not discuss suicidal plans with their doctor. That, in turn, leads to their under-treatment and increases the likelihood of suicide.
Another is access to care. Effective mental health care should involve easy access to a variety of clinical resources and interventions. These include follow-up phone calls from a healthcare professional, continued telehealth visits, and virtual check-ins on weekends or when people aren’t where they should be in their daily lives (e.g., school or work).
Cost is a third barrier and is one of the most frequently cited barriers to mental health treatment. People with mental illness are more likely to be low-income and uninsured. That is where passage of the Affordable Care Act (ACA) has helped. Before ACA, there were more than 48 million uninsured people. Now, ample evidence shows that the ACA significantly increased insurance coverage in the United States and enhanced access to affordable health services, including mental health.
Family and Friends
Family members and friends can be the first line of defense in preventing suicide. But that means they need to know the signs and symptoms, what actions to take, and whom to call if they suspect a relative or friend is in danger of harming themselves.
Suicidal warning signs should never be taken lightly. While some signs are obvious, such as talking about suicide and dying, others are much more subtle and easily missed. It is vital to know the signs as early detection can mean the difference between life and death.
The following resources can help families and friends learn the warning signs, risk factors, and steps to take:
- National Suicide Prevention Lifeline
- American Foundation for Suicide Prevention
- American Psychiatric Association
Schools are an instrumental setting for suicide prevention. Teachers, mental health providers, and other school personnel who interact with students can play a crucial role in keeping them safe.
SPRC advises schools to promote emotional wellbeing and connectedness among all students, identify students who may be at risk for suicide, assist them in getting help, and be prepared to respond when a suicide death occurs.
Student Reach, a student empowerment organization, says schools should enlist students to work with mental health professionals (e.g., nurse, counselor, or psychologist) to develop a safety plan for when a student is feeling suicidal. It also recommends that schools present suicide prevention programs, assemble a crisis team to identify potentially at-risk students, and involve parents.
AFSP offers a suicide prevention education program for teachers and other school personnel called More Than Sad. It helps educators recognize signs of mental health distress in students and refer them for help.
Companies are gaining increased awareness of the need to address suicide prevention in the workplace, both from a business cost and social responsibility perspective.
Approximately 80 percent of all people who die by suicide are of working age (18-65), making the workplace an ideal location for suicide prevention, intervention, and crisis response.
SPRC recommends workplaces implement the following components:
- Create a work environment that fosters communication, sense of belonging, connectedness, and respect;
- Identify and assist employees who may be at risk for suicide;
- Be prepared to respond to a suicide death.
The community is another important setting for suicide prevention. A wide variety of community groups and organizations, including schools, after-school programs, health care providers, workplaces, and places of worship, can work together to carry out prevention activities that reflect local needs and resources.
“Forming a broad-based suicide prevention coalition can be an essential first step to understanding the suicide problem in your community and identifying the strategies that may be most appropriate and effective,” SPRC says.
In that vein, the CDC has a that encourage a comprehensive public health approach. It includes strengthening economic supports and access and delivery of care, creating protective environments, promoting connectedness, and teaching coping and problem-solving skills.
Although suicide is a severe public health problem that can have long-lasting effects on individuals, families, and communities, the good news is that suicide is preventable. However, it requires a multisectoral partnership approach involving individuals, families, medical practitioners, schools, workplaces, and communities.
Everyone can help prevent suicide by learning the warning signs, promoting prevention and resilience, providing access to care, and fostering social change. We each have a role to play, so let’s all commit to doing our part.
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or the Crisis Text Line by texting HOME to 741741.