New Community-Based Tools Set to Curb Rising Suicide Rates

Alicia Ault

April 13, 2017

The Centers for Disease Control and Prevention (CDC) and several suicide prevention organizations have a goal of reducing suicide by 20% by 2025. They have released several new toolkits to assist communities and clinicians to meet this goal.

The new guidebooks are built on a program developed to help prevent suicide in the healthcare setting, Zero Suicide. They are different because they are tailored specifically for the community setting, said Jerry Reed, PhD, director of the Suicide Prevention Resource Center, which is supported by the Substance Abuse and Mental Health Services Administration.

"Theoretically, what we do in the community should link to what's being done in the clinical setting," said Dr Reed during a webinar explaining the new tools. He said if an individual who is identified through community tools as being at risk needs a clinical intervention, he or she "would go through the door of a setting that is prepared to deliver that suicide safer care, and at the end of the process is well on the way to recovery, with their challenge being addressed effectively and efficiently by a well-prepared healthcare system," he said.

"But it started at the community that was equally as well prepared," said Dr Reed.

Suicide on the Rise

Suicide rates have been on the rise during the past 16 years in the United States. It is the tenth leading cause of death, with some 44,000 Americans killing themselves each year, according to the American Foundation for Suicide Prevention (AFSP). Half of suicides are by firearms, said the AFSP.

In late January, the AFSP, a nonprofit organization, joined with the National Action Alliance for Suicide Prevention, a 250-group public-private organization that is advancing the National Strategy for Suicide Prevention, to work together toward the 20% reduction by 2025 goal.

"We know that suicide is preventable," said James Mercy, PhD, director of the CDC's Division of Violence Prevention, National Center for Injury Prevention and Control, in a statement. "These resources will help communities to start now, act on the best available evidence, and work together," he said.

The first guide, Transforming Communities , presents seven key elements for comprehensive community-based suicide prevention. The idea was to replicate the successful Zero Suicide program, which offers strategies and tools to prevent suicide in healthcare settings, said Dr Reed.

"There is so much out there already nationally and internationally that talks about what communities can do to reduce the burden," he said.

He and his colleagues reviewed existing programs and determined common elements. They also reviewed the literature to find a "robust body of evidence" on what worked, said Dr Reed.

They synthesized their findings, creating seven key elements that are to function as a road map for communities looking to establish comprehensive suicide prevention programs.

Urgent Problem

The second guide, Preventing Suicide , was developed by the CDC. It attempts to provide the best evidence for prevention interventions, along with seven strategies for suicide prevention.

"Urgent problems require solutions based on the best available evidence," said the CDC's Dr Mercy.

He said, "We need to have people understand the urgency of this problem," calling it as pressing an issue as the opioid epidemic, which is partially intertwined with suicide.

"We do not have perfect evidence to prevent suicide," he said. But evidence exists to show that many strategies do work, he said.

The CDC guide — which the CDC is calling a technical package ― highlights seven strategies, arranged according to impact they would have in reducing population-level suicide if widely implemented, said Dr Mercy. The toolkit also discusses policies and practices that can be used to actualize the strategies.

The seven strategies, with some of the suggestions for putting them into action, are as follows:

  • Strengthen economic supports by having housing stabilization policies

  • Strengthen access and delivery of suicide care by covering mental health conditions in health insurance, reducing provider shortages in underserved areas, and providing safer suicide care

  • Create protected environments by reducing access to lethal means of suicide

  • Promote connectedness through community engagement

  • Teach coping and problem solving skills through social-emotional learning programs

  • Identify and treat people at risk through crisis intervention; provide treatment for people at risk for suicide and treatment to prevent repeat attempts

  • Lessen harms to prevent future risk by post-intervention and and by providing safe reporting and messaging about suicide in the media

    "The strategies laid out in the technical package, as well as the key elements outlined in the paper, are intended to work in combination and reinforce each other," said Dr Mercy.

    The National Action Alliance for Suicide Prevention is supported by grants from the Substance Abuse and Mental Health Services Administration. Dr Reed and Dr Mercy have disclosed no relevant financial relationships.

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