By Doryn Chervin, DrPH, Executive Secretary of the National Action Alliance for Suicide Prevention and Vice President and Senior Scientist at Education Development Center, Inc.
The National Action Alliance for Suicide Prevention (Action Alliance) continues to work toward fulfilling a vision of a nation free from the tragedy of suicide. As executive secretary of the Action Alliance, I am incredibly grateful to the members of this public-private partnership for their ongoing dedication and efforts to champion, catalyze, and cultivate suicide prevention as a national priority.
The last 18 months have been exceptionally noteworthy. The vision, perseverance, and accomplishments of our Executive Committee, Task Forces, and Tiger Teams have resulted in steady progress in advancing the objectives of the 2012 National Strategy for Suicide Prevention. I would like to acknowledge some of the many Action Alliance members whose contributions have made a significant and lasting impact in the field of suicide prevention.
In March 2015, under the leadership of Research Prioritization Task Force co-leads Thomas Insel (National Institute of Mental Health [NIMH]) and Phillip Satow (Jed Foundation), the Action Alliance released U.S. National Suicide Prevention Research Efforts: 2008-2013 Portfolio Analyses. This report showed that investments in suicide research are severely lagging relative to research on other leading causes of death. The Portfolio Analyses calls for a large-scale research investment focused on a comprehensive prevention strategy and timely and effective evidence-based interventions. This report was made possible only through the herculean efforts of Jane Pearson from NIMH. She deserves all of our gratitude for her tireless work on this important initiative.
Also deserving of our thanks is each and every person who contributed his or her time and expertise to the development of two important sets of guidelines released by the Action Alliance. Special thanks go to the co-leads of our Clinical Workforce Task Force, Brian Boon (CARF International) and Alexander Ross (Health Resources and Services Administration). In November 2014, this task force released Suicide Prevention and the Clinical Workforce: Guidelines for Training. This resource will help assure that the nation’s clinical workforce is prepared to treat persons at risk for suicide. Under the leadership of Drs. Boon and Ross, the task force spent more than three years creating guidelines which can serve as the foundation for creating suicide prevention training programs in health and human services professions. Gratitude is also due to Lori Rogers (CARF) for her time and contributions to this important work.
I also would like to acknowledge Franklin Cook (Unified Community Solutions), Karen Moyer (Moyer Foundation), and John Jordan (Family Loss Project), the co-leads of the Action Alliance’s Survivors of Suicide Loss Task Force. Their hard work and dedication brought forth the landmark report Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines. This publication, released in April 2015, is a set of comprehensive and strategic guidelines detailing how communities can effectively respond to the devastating impact of suicide loss. These guidelines pave the way for decisive advances in postvention. Responding to Grief also puts forth a call to strengthen and expand care to meet the needs of the bereaved and others who suffer from the effects of suicide loss.
A very special thanks is due the Action Alliance’s Faith Communities Task Force which, in September 2014, launched the Your Life Matters! campaign. Your Life Matters! is an opportunity for any faith community to focus one Sabbath each year on the core characteristics common to most faiths that help prevent suicides.The task force co-leads, Talitha Arnold (Unified Church of Santa Fe), Anne Matthews-Younes (Substance Abuse and Mental Health Services Administration), and David Litts (formerly with SPRC) worked diligently on the campaign’s successful launch and are true stewards, serving those in suicidal despair through their work with faith leaders and faith communities.
Several members of the Action Alliance’s Public Awareness and Education Task Force have contributed significantly to suicide prevention educational programs and resources. Jack Benson (Reingold, Inc.) and Dan Reidenberg (Suicide Awareness Voices of Education), along with partners from the Department of Veterans Affairs, the American Foundation for Suicide Prevention, and SPRC were instrumental in establishing the Poynter/Action Alliance Covering Suicide and Mental Health Reporting Institutes. In one year these educational sessions equipped 90 journalists from 30 states with the tools to produce balanced and safe suicide prevention coverage.
Finally, I wish to recognize and celebrate the accomplishments of Public Awareness and Education Task Force co-lead Brian Dyak (Entertainment Industries Council, Inc.) for the Council’s ongoing development of educational resources: Social Media Guidelines for Mental Health Promotion and Suicide Prevention and Entertainment and Media Depiction Suggestions for Portraying Behavioral Health Conditions: Mental Illness and Substance Abuse Disorders.
Again, to all our hard-working and committed volunteers, thank you!
This post has been cross-posted on the Suicide Prevention Resource Center website.
Showing posts with label National Strategy for Suicide Prevention. Show all posts
Showing posts with label National Strategy for Suicide Prevention. Show all posts
Thursday, July 9, 2015
Monday, April 13, 2015
What We Know (and What We Don’t) About Predicting Suicide Risk
By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Dr. Lisa Colpe, National Institute of Mental Health; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat
Screening for suicide risk is common to most suicide prevention efforts and clinical practices that aim to identify at-risk individuals. To reduce suicide’s burden, there are a number of research-supported screening and risk detection tools to employ, but there is no doubt that further research is necessary to better understand the various factors that put people at risk of suicide.
The Continuum of Suicide Risk
Ideas about screening reflect our assumptions about a continuum of suicide risk—it is assumed there is a progression of suicide ideation, plans and eventual behavior (i.e., suicide attempts, suicide death). For example, multinational surveys have found that about a third of individuals who think about suicide make a plan and about a third go on to attempt suicide. Meanwhile, another subgroup reports having made an attempt with little or no ideation or planning.
Active versus Passive Ideation
Current approaches to assessing risk are heavily weighted toward identifying active ideation with a plan versus passive ideation (e.g., desire for death). However, some studies have found that passive ideation is just as strongly associated with morbidity as active ideation.
Screening Approaches
Many stakeholders consider screening for suicide risk an essential step in reducing suicides—and there are many opportunities to screen. Holding an annual depression screening day in the workplace or a school screening event following a suicide are two community examples. Screenings can be standalone, web-based for use in public settings or clinical tools (e.g., PHQ-9) integrated into primary care or other intake procedures to detect and monitor depression with suicide ideation. In fact, research looking at a large set of electronic health record data found a six-fold increased risk for suicide attempt (includes 709 attempts and 46 deaths) if someone responded ‘every day’ to the question, “Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or hurting yourself in some way?” on PHQ-9.
Screening within Health Systems
Screening practices are ahead of research. The Joint Commission recommends screening in all medical care settings to prevent suicide attempts and deaths. However, health care settings vary with regard to the proportion of patients at risk and the steps necessary to get identified patients to adequate care. In any setting, risk detection alone will not reduce suicide. Assessment, adequate intervention and ongoing monitoring must support screening and detection efforts to have the desired impact of reduced suicidal behavior.
Promising Research
Research links neurocognitive science with risk detection and screening. For example, the Suicide Implicit Association Task (IAT) has shown to improve prediction of who will attempt suicide in the future. It examines reaction times to ‘life’ and ‘death’ words and can be administered on the computer in 5-10 minutes. It is currently being studied in emergency department environments with both youth and adults.
Recent research has also identified specific genetic markers for suicidal behavior, but the studies require replication before having a role in clinical practice.
How Can Risk Detection Contribute to Achieving a 20% Reduction in Suicide?
There are a number of ways to model how our nation could achieve a 20% reduction in suicides. One strategy is to stratify risk and identify those in the high-risk group due to risk factors and those in the low-risk group due to risk and protective factors. If we can identify those in the high-risk group and intervene so we move more individuals into the lower part of the triangle (see graphic), we can begin to reduce suicide’s burden on our nation.
On January 29, the National Council launched a six-part webinar series highlighting the National Action Alliance for Suicide Prevention’s Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This series is a collaborative effort between the National Council for Behavioral Health,National Action Alliance for Suicide Prevention and the National Institute of Mental Health. Subsequent webinars will describe how this current understanding influences detecting those at risk, clinical care and services, as well as highlighting a number of the pressing research needs to reduce the burden of suicide. For more information about this webinar series, see Linda Rosenberg’s recent blog post announcing this collaboration.
This post has been cross-posted on the National Council for Behavioral Health site.
Screening for suicide risk is common to most suicide prevention efforts and clinical practices that aim to identify at-risk individuals. To reduce suicide’s burden, there are a number of research-supported screening and risk detection tools to employ, but there is no doubt that further research is necessary to better understand the various factors that put people at risk of suicide.
The Continuum of Suicide Risk
Ideas about screening reflect our assumptions about a continuum of suicide risk—it is assumed there is a progression of suicide ideation, plans and eventual behavior (i.e., suicide attempts, suicide death). For example, multinational surveys have found that about a third of individuals who think about suicide make a plan and about a third go on to attempt suicide. Meanwhile, another subgroup reports having made an attempt with little or no ideation or planning.
Active versus Passive Ideation
Current approaches to assessing risk are heavily weighted toward identifying active ideation with a plan versus passive ideation (e.g., desire for death). However, some studies have found that passive ideation is just as strongly associated with morbidity as active ideation.
Screening Approaches
Many stakeholders consider screening for suicide risk an essential step in reducing suicides—and there are many opportunities to screen. Holding an annual depression screening day in the workplace or a school screening event following a suicide are two community examples. Screenings can be standalone, web-based for use in public settings or clinical tools (e.g., PHQ-9) integrated into primary care or other intake procedures to detect and monitor depression with suicide ideation. In fact, research looking at a large set of electronic health record data found a six-fold increased risk for suicide attempt (includes 709 attempts and 46 deaths) if someone responded ‘every day’ to the question, “Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or hurting yourself in some way?” on PHQ-9.
Screening within Health Systems
Screening practices are ahead of research. The Joint Commission recommends screening in all medical care settings to prevent suicide attempts and deaths. However, health care settings vary with regard to the proportion of patients at risk and the steps necessary to get identified patients to adequate care. In any setting, risk detection alone will not reduce suicide. Assessment, adequate intervention and ongoing monitoring must support screening and detection efforts to have the desired impact of reduced suicidal behavior.
Promising Research
Research links neurocognitive science with risk detection and screening. For example, the Suicide Implicit Association Task (IAT) has shown to improve prediction of who will attempt suicide in the future. It examines reaction times to ‘life’ and ‘death’ words and can be administered on the computer in 5-10 minutes. It is currently being studied in emergency department environments with both youth and adults.
Recent research has also identified specific genetic markers for suicidal behavior, but the studies require replication before having a role in clinical practice.
How Can Risk Detection Contribute to Achieving a 20% Reduction in Suicide?
There are a number of ways to model how our nation could achieve a 20% reduction in suicides. One strategy is to stratify risk and identify those in the high-risk group due to risk factors and those in the low-risk group due to risk and protective factors. If we can identify those in the high-risk group and intervene so we move more individuals into the lower part of the triangle (see graphic), we can begin to reduce suicide’s burden on our nation.
This post has been cross-posted on the National Council for Behavioral Health site.
Tuesday, September 9, 2014
Breaking the Silence – Learning from the experience of Suicide Attempt Survivors
By Doryn Chervin, Action Alliance Executive Secretary
Vice President and Senior Scientist, Health and Human Development Division, Education Development Center, Inc.
We live during a time, for better or worse, in
which suicide is prominently covered in the media. Whether the story is a
high-profile suicide, the ongoing fight to prevent military and veteran
suicide, or other tragic stories of grief and loss, there is one voice that has
been missing – the voice of the suicide attempt survivor. There is a movement
underway to change this. Suicide attempt
survivors are emerging with a collective voice and a plan for re-shaping the
delivery of suicide care in health care, strengthening community services, and improving
suicide prevention efforts.
This Suicide Prevention Week, September 8 – 14, we embrace and support the suicide attempt survivor movement. For
far too long, the perspectives of those with lived experience of suicide have
not been integrated into treatment services and suicide prevention efforts.
Whether this was due to fear, stigma, shame, or other reasons – the important
fact is that this is changing.
For the many thousands of Americans who are
now living as attempt survivors, their experience of resiliency and lived
experience is an untapped resource that could potentially advance suicide
prevention and save the lives of others in suicidal despair. They understand better than providers or
researchers how to find meaning in the midst of great darkness.
The National
Action Alliance for Suicide Prevention (Action
Alliance) is the nation’s public-private partnership advancing the National Strategy for Suicide Prevention and championing suicide prevention as a national priority. The
Action Alliance’s Suicide Attempt Survivors Task Force, recently released a groundbreaking report, The Way Forward, which makes recommendations to improve our nation’s health
systems, emergency services, and suicide prevention efforts based on the
experience of attempt survivors. This report, which incorporates the lived
experience of recovery and resilience, provides the missing bridge between suicide attempt survivors and treatment services,
suicide prevention leaders, and policy makers.
The Way Forward marks the beginning of a new era, in which families, communities, clinicians, and health systems do not fear persons with a known history of suicidal thoughts and behaviors. Similar fears and concerns were once directed at persons with histories of mental illness, and alcohol or drug abuse; yet we have increasingly benefited and learned from the inclusion of persons with these lived experiences.
Let’s mark this week, 2014 Suicide Prevention
Week, as the moment when families, communities, and organizations commit to fully
supporting suicide attempt survivors in their recovery and in our efforts.
As the Executive Secretary of the Action Alliance, I welcome this
movement. I welcome the stories of survival, hope, and recovery that suicide
attempt survivors contribute to the cause of suicide prevention. The era of
silence is over. Just as people once whispered about cancer, we will one day
look back in wonder that we ever whispered about this.
If you, or someone you know is in crisis (no matter how small or
big), help is available. By
calling the 24/7 National Lifeline, 1-800-273-TALK (8255), you’ll be connected to a skilled,
trained counselor who will help you find a reason to keep living.
Doryn Chervin, Dr.P.H., M.Ed.
Executive Secretary, National Action Alliance for Suicide PreventionVice President and Senior Scientist, Health and Human Development Division, Education Development Center, Inc.
Thursday, April 3, 2014
A Vision for Research
By Phillip Satow, Private Sector Co-lead, Research Prioritization Task Force, National Action Alliance for Suicide Prevention; Representative, National Council for Suicide Prevention; Chair of the Board, The Jed Foundation
At the end of 1998 I lost my son Jed to suicide. Since then, like so many survivors, caregivers, and advocates, I have worked hard to understand this unendurable tragedy. Sixteen years later, I am happy to be part of the creation of A Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This blueprint, if implemented, has a high probability of making a significant impact on our knowledge of suicidal behavior and, most importantly, on the suicide rate itself. The Agenda is a product of the Research Prioritization Task Force of the National Action Alliance for Suicide Prevention, a public-private partnership whose mission is to advance the National Strategy for Suicide Prevention. I have the honor of being the private sector co-chair of this task force. The public sector co-chair is Dr. Tom Insel, Director of the National Institute of Mental Health.
Our task force had a vision — a vision of creating a paradigm based on the careful prioritization of suicide research efforts. How else could we allocate our limited resources as effectively as possible to prevent the maximum number of people from taking their own lives?
Our activities in the mental health 501(c)3 world tend to fall into silos. That is, our organizations generally focus their programming and funding within particular DSM categories or illnesses. We know, however, that there are often associated symptoms, co-morbidities, and other complications that caregivers cannot ignore during treatment. For example, substance abuse is associated with many mental illnesses, while symptoms of depression and anxiety disorders may be associated with each of a full spectrum of disorders.
In addition, there is a connection between suicide and emotional illnesses that is stronger than most people realize. Suicide mortality in populations with a mental disorder is about three times that of the general population. Depressed patients have a 20-fold greater lifetime risk for suicide than the general population. Bipolar illness, panic disorder, and schizophrenia are also associated with suicide risk. These associations speak to the interdisciplinary nature of our mission. We all need to understand the brain better than we do if we hope to progress, not only in suicide prevention but in finding better treatments for all illnesses of the brain. Clearly, improving our prospects for suicide research and discovering better approaches to prevent self-harm will benefit all of our respective missions and our common goal of preventing suicide.
Unfortunately the suicide rate has not decreased appreciably in the last 50 years. It’s hard to believe that nearly 700,000 individuals annually report having received medical attention for a suicide attempt each year. Nearly 40,000 people die by their own hand annually. The number of suicide deaths over the years 2000-2009 increased by nearly 26 percent. During the same period, mortality from HIV, asthma, heart disease, and many cancers has declined.
Each year, we spend 40-50 million dollars on suicide research in the United States. The vast majority of these funds come from the National Institute of Mental Health. However, other organizations, like the American Foundation for Suicide Prevention, also fund research. If we added Veterans Administration and Department of Defense expenditures, the total would be somewhat higher.
Doesn’t it make sense that these funds should be directed to the projects most likely to advance our knowledge base and reduce the suicide rate? I am confident that we all agree that there is no lack of ideas emanating from our research community. But how can we feel confident that funds are directed toward establishing research pathways that would truly reduce the burden of suicide in an optimal manner? The question always remains: if funding was increased, if new funding was developed, how should it be allocated?
There has never been a reluctance to recognize the need for a research agenda. However, because of a combination of the lack of sufficient funding, the lack of an appropriate implementation vehicle, and the inability to galvanize the many disciplines required for the effort, we have not been able to systematically address that need until now. The 2002 Institute of Medicine report Reducing Suicide: A National Imperative recognized the importance of interdisciplinary research on suicide. Both the original National Strategy for Suicide Prevention promulgated by Surgeon General Satcher and its 2012 update explicitly call for a research agenda. The long elusive goal of completing a targeting agenda has now been accomplished.
At the urging of Tom Insel, the Task Force established a specific numerical goal for reducing suicide burden. We set a goal of developing an agenda for research that, if fully implemented, has the potential to reduce morbidity and mortality by at least 20 percent in five years and 40 percent in ten years. This goal is aggressive and far-reaching — but doable! The achievement of our task force’s goal in five years could lower the suicide rate to less than 10/100,000 and less than 8/100,000 in ten years.
We also agreed that we needed a broad sampling of stakeholders in our field — survivors, caregivers and researchers — to inform us of their personal aspirational goals for future suicide prevention research. More than 700 people who have been touched by suicide answered our questionnaire. The many hundreds of aspirational goals offered by stakeholders were reduced to 12 that were deemed to be of highest priority.
A literature search was conducted, followed by a portfolio analysis which documented the state of ongoing research studies. Opinion-leading scientific minds weighed in to help design or identify research pathways to achieve the prioritized aspirational goals which represented the "wishes," if you will, of the suicide community.
With research pathways identified, the task force and our advisors and experts established short- and long-term research objectives. The recommended pathways and objectives are central to the final task force product and to the achievement of our underlying goal.
So, why do we think it can be achieved? We conducted a systematic review of available suicide death and attempt surveillance, data which helped to uncover promising areas of future research. We developed several models of interventions to estimate the potential benefit for individuals at risk within boundaried communities (enclosed entities like our criminal justice system, college campuses, integrated health care complexes, and HMOs). There are more than two million suicide attempts in boundaried communities. Developing effective interventions for these environments has the potential to bring about major reductions in attempt rates.
Critical to achieving our goals is funder cooperation and transparency. And we must not forget the amount of hard work that mental and health supporters put into advocating for an increase in federal funding for suicide research.
The implementation plan for the task force's final report is critical. We expect all the key funders of suicide research to familiarize themselves with its content. We hope that future funding will be directed at the objectives that are clearly outlined in the agenda. The task force expects that the details of its work will be broadly disseminated and will appear in widely read scientific journals. We hope that researchers will focus their efforts on priorities consistent with those suggested in the plan. We also hope that future funding will be allocated to studies that incorporate thematic elements highlighted across multiple pathways, for example, the increased use of common data elements, banking and sharing to leverage research investments, fielding practical research designs, and finding service quality improvements to reduce suicide.
Lastly, I expect that stakeholders, whose aspirational goals are targets for achievement, will now have a potential rallying point and that they will find the task force’s research priorities understandable and see them connected to their own aspirations and to potential reductions in suicide burden. They may also appreciate the broad definition of research that the document considers, including services research, outcomes research, and prevention research — research that for many may have a more direct and practical association to suicide prevention programing.
Most importantly, we can’t let the agenda sit on a shelf. The potential to save thousands of lives, including those of so many military personnel and veterans, deserves support. I hope each of you can help foster a groundswell of awareness and support for this unique opportunity to help move the suicide prevention field forward.
At the end of 1998 I lost my son Jed to suicide. Since then, like so many survivors, caregivers, and advocates, I have worked hard to understand this unendurable tragedy. Sixteen years later, I am happy to be part of the creation of A Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives. This blueprint, if implemented, has a high probability of making a significant impact on our knowledge of suicidal behavior and, most importantly, on the suicide rate itself. The Agenda is a product of the Research Prioritization Task Force of the National Action Alliance for Suicide Prevention, a public-private partnership whose mission is to advance the National Strategy for Suicide Prevention. I have the honor of being the private sector co-chair of this task force. The public sector co-chair is Dr. Tom Insel, Director of the National Institute of Mental Health.
Our task force had a vision — a vision of creating a paradigm based on the careful prioritization of suicide research efforts. How else could we allocate our limited resources as effectively as possible to prevent the maximum number of people from taking their own lives?
Our activities in the mental health 501(c)3 world tend to fall into silos. That is, our organizations generally focus their programming and funding within particular DSM categories or illnesses. We know, however, that there are often associated symptoms, co-morbidities, and other complications that caregivers cannot ignore during treatment. For example, substance abuse is associated with many mental illnesses, while symptoms of depression and anxiety disorders may be associated with each of a full spectrum of disorders.
In addition, there is a connection between suicide and emotional illnesses that is stronger than most people realize. Suicide mortality in populations with a mental disorder is about three times that of the general population. Depressed patients have a 20-fold greater lifetime risk for suicide than the general population. Bipolar illness, panic disorder, and schizophrenia are also associated with suicide risk. These associations speak to the interdisciplinary nature of our mission. We all need to understand the brain better than we do if we hope to progress, not only in suicide prevention but in finding better treatments for all illnesses of the brain. Clearly, improving our prospects for suicide research and discovering better approaches to prevent self-harm will benefit all of our respective missions and our common goal of preventing suicide.
Unfortunately the suicide rate has not decreased appreciably in the last 50 years. It’s hard to believe that nearly 700,000 individuals annually report having received medical attention for a suicide attempt each year. Nearly 40,000 people die by their own hand annually. The number of suicide deaths over the years 2000-2009 increased by nearly 26 percent. During the same period, mortality from HIV, asthma, heart disease, and many cancers has declined.
Each year, we spend 40-50 million dollars on suicide research in the United States. The vast majority of these funds come from the National Institute of Mental Health. However, other organizations, like the American Foundation for Suicide Prevention, also fund research. If we added Veterans Administration and Department of Defense expenditures, the total would be somewhat higher.
Doesn’t it make sense that these funds should be directed to the projects most likely to advance our knowledge base and reduce the suicide rate? I am confident that we all agree that there is no lack of ideas emanating from our research community. But how can we feel confident that funds are directed toward establishing research pathways that would truly reduce the burden of suicide in an optimal manner? The question always remains: if funding was increased, if new funding was developed, how should it be allocated?
There has never been a reluctance to recognize the need for a research agenda. However, because of a combination of the lack of sufficient funding, the lack of an appropriate implementation vehicle, and the inability to galvanize the many disciplines required for the effort, we have not been able to systematically address that need until now. The 2002 Institute of Medicine report Reducing Suicide: A National Imperative recognized the importance of interdisciplinary research on suicide. Both the original National Strategy for Suicide Prevention promulgated by Surgeon General Satcher and its 2012 update explicitly call for a research agenda. The long elusive goal of completing a targeting agenda has now been accomplished.
At the urging of Tom Insel, the Task Force established a specific numerical goal for reducing suicide burden. We set a goal of developing an agenda for research that, if fully implemented, has the potential to reduce morbidity and mortality by at least 20 percent in five years and 40 percent in ten years. This goal is aggressive and far-reaching — but doable! The achievement of our task force’s goal in five years could lower the suicide rate to less than 10/100,000 and less than 8/100,000 in ten years.
We also agreed that we needed a broad sampling of stakeholders in our field — survivors, caregivers and researchers — to inform us of their personal aspirational goals for future suicide prevention research. More than 700 people who have been touched by suicide answered our questionnaire. The many hundreds of aspirational goals offered by stakeholders were reduced to 12 that were deemed to be of highest priority.
A literature search was conducted, followed by a portfolio analysis which documented the state of ongoing research studies. Opinion-leading scientific minds weighed in to help design or identify research pathways to achieve the prioritized aspirational goals which represented the "wishes," if you will, of the suicide community.
With research pathways identified, the task force and our advisors and experts established short- and long-term research objectives. The recommended pathways and objectives are central to the final task force product and to the achievement of our underlying goal.
So, why do we think it can be achieved? We conducted a systematic review of available suicide death and attempt surveillance, data which helped to uncover promising areas of future research. We developed several models of interventions to estimate the potential benefit for individuals at risk within boundaried communities (enclosed entities like our criminal justice system, college campuses, integrated health care complexes, and HMOs). There are more than two million suicide attempts in boundaried communities. Developing effective interventions for these environments has the potential to bring about major reductions in attempt rates.
Critical to achieving our goals is funder cooperation and transparency. And we must not forget the amount of hard work that mental and health supporters put into advocating for an increase in federal funding for suicide research.
The implementation plan for the task force's final report is critical. We expect all the key funders of suicide research to familiarize themselves with its content. We hope that future funding will be directed at the objectives that are clearly outlined in the agenda. The task force expects that the details of its work will be broadly disseminated and will appear in widely read scientific journals. We hope that researchers will focus their efforts on priorities consistent with those suggested in the plan. We also hope that future funding will be allocated to studies that incorporate thematic elements highlighted across multiple pathways, for example, the increased use of common data elements, banking and sharing to leverage research investments, fielding practical research designs, and finding service quality improvements to reduce suicide.
Lastly, I expect that stakeholders, whose aspirational goals are targets for achievement, will now have a potential rallying point and that they will find the task force’s research priorities understandable and see them connected to their own aspirations and to potential reductions in suicide burden. They may also appreciate the broad definition of research that the document considers, including services research, outcomes research, and prevention research — research that for many may have a more direct and practical association to suicide prevention programing.
Most importantly, we can’t let the agenda sit on a shelf. The potential to save thousands of lives, including those of so many military personnel and veterans, deserves support. I hope each of you can help foster a groundswell of awareness and support for this unique opportunity to help move the suicide prevention field forward.
This post was cross-posted on the Suicide Prevention Resource Center's Director's Corner.
Tuesday, March 25, 2014
“Lighting the Way Forward”: The National Summit on Lived Experience in Suicide Prevention
By Eduardo Vega and John Draper, Suicide Attempt Survivors Task Force co-leads, and David Covington, Zero Suicide Advisory Group co-lead, National Action Alliance for Suicide Prevention
In the words of Leah Harris, communications director for the
National Empowerment Center, who is also on both the SAS TF and ZSAG: “After my
suicide attempts, I experienced re-traumatizing treatments from systems that
were supposed to help me. For years, I also felt the attempt survivor’s voice
was not valued in suicide prevention. But that is changing. Today, we built
trust, and a lot of healing took place."
On March 5-6, a landmark meeting occurred between two groups
of the National Action Alliance for Suicide Prevention (Action Alliance). Members
of the Suicide
Attempt Survivors Task Force (SAS TF) met with leaders of the Zero
Suicide Advisory Group (ZSAG) to discuss, in detail, how the values,
insight, and expertise of people with lived experience of suicide can create
better supports and services to reduce suicide for those in clinical care. Held
in San Francisco through the support of the Mental Health Association of San
Francisco, the National Suicide Prevention Lifeline (Lifeline), the Suicide
Prevention Resource Center (SPRC), and the Substance Abuse and Mental Health
Services Administration (SAMHSA), the Summit on Lived Experience in Suicide
Prevention may be the first time in history that a major national care
initiative such as Zero Suicide has
engaged with people ‘who have been there’ to strategize directions for
fostering healthier communities and preventing suicide death.
The Summit involved leadership from the Action Alliance’s
Executive Committee and Suicide Attempt Survivors Task Force, including John
Draper and Eduardo Vega, and the Zero Suicide Advisory Group, including David
Covington, CEO & President of Crisis Access, LLC, and Becky Stoll, Vice
President for Crisis and Disaster Management, Centerstone of America. Members
of the SAS TF from around the nation participated actively throughout the
Summit. Reflecting the Summit’s significance
and importance, Richard McKeon, SAMHSA’s Suicide Prevention Branch Chief, Jerry
Reed, Director of SPRC, and Sally
Spencer-Thomas, AAS board member and director of the innovative Carson J.
Spencer Foundation, were also active participants.
The meeting
of these two groups was one of intense dialogue and progress, and a true
spirit of mutual interest was fostered through discussion of each other’s work.
As Vega, co-lead for the SAS TF pointed
out, “Today we are a team. We are finding ways to support each other’s efforts
and bringing our energies and values into alignment. In doing so, we are
radically changing thinking about suicide prevention, setting the stage for
innovation that brings the expertise of attempt survivors into focus with that of
our healthcare providers.”
A major focus of the meeting was a pivotal technical
document “The Way Forward”, soon to be released by the SAS TF, which lays out
recommendations for policies, practices, and programs to support people
experiencing suicidal thoughts and feelings and for the engagement of people
with this ‘lived expertise’ in services and systems change. This document, in
development for over two years by SAS TF members, builds on the 2012 National Strategy on Suicide Prevention
and provides a core values framework that advances the conversation. Bringing its recommendations into focus with
the priorities of Zero Suicide is a bold concrete step for change in the way
services and providers think about prevention of suicide. As Covington, co-lead
of the ZSAG, remarked, “Wherever Zero Suicide is developed, we need lived
expertise to be ‘baked in, not bolted on’ to the project.”
Draper, director of the Lifeline, who brings his leadership
to both the SAS TF and ZSAG, outlined the value of the collaboration directly: "'Zero
Suicide' is a goal that we can aspire to only if clinicians and persons who
have a history of suicidal thoughts or actions collaborate in ways that enable
choice, trust, and shared responsibility. This meeting was a perfect model for
the kind of collaboration that will build connectedness, hope, and meaning for
persons seeking help for suicidal thoughts in clinical systems of care."
In addition to strategic directions for collaboration and
support, summit attendees discussed crucial issues related to the field of
suicide prevention, including: risk, community intervention practices, stigma
and prejudice, and other historical challenges to progress. For example, although
mental health service providers have developed extensive dialogue with their
service ‘consumers’ over many years, and lived expertise in the area has
resulted in many new and transformed programs, the suicide prevention community
has historically had very limited dialogue with people with lived experience of
suicidality. This history of disengagement was broached openly.
Wednesday, February 5, 2014
A New Research Agenda for Suicide Prevention
By Thomas Insel
More than 38,000 Americans died by suicide in 2010, the
most recent year for which we have national data. This makes suicide, once
again, the tenth leading cause of death for all ages; the second leading cause
of death for young adults ages 25 to 34.1 Despite changes
in recent decades that might reasonably have been expected to reduce suicide
rates—increased awareness about mental disorders, the availability of
treatment, and community-based public health efforts aimed directly at
preventing suicide—U.S. rates of suicide deaths have not decreased. In fact,
suicide has proven stubbornly difficult to understand, to predict, and to
prevent.
This grim reality contrasts with the successes achieved
in other areas of medicine and prevention. Death rates from heart disease,
cancer, traffic accidents, and homicides are all declining. For heart disease
and cancer, research has identified risk factors as well as new pathways to
prevention and treatment. Changes in automobile design along with road safety
measures have contributed to an ongoing reduction in traffic deaths. Homicides
now number less than half the annual total of deaths by suicide in this
country.
Why is suicide different? There are a number of public
health approaches, from redesigned bridges and buildings to firearm safety,
that need the kind of aggressive engineering and policy approaches we have seen
with automobile safety. And, learning from heart disease and cancer, we can do
better detecting and helping individuals at risk. Despite our best efforts, it
remains very difficult to predict who will attempt suicide and, thus, difficult
to intervene. The presence of mental illness is a risk factor, but it is not
universally present or identified in those who attempt suicide. Treatment can
be effective, but too many high-risk individuals are not getting the effective
care they need. Suicide remains one of the top five sentinel events
(unanticipated events resulting in serious injury or death) for health care
systems.2 To reduce
suicide, we need to know how to target our efforts: to be able to reliably
identify who is at risk, how to reach them, and how to deter them from acting
on suicidal thoughts.
In a blog post last September, I
talked about a newly updated National Strategy for Suicide Prevention and
the research agenda being developed by a task force of the National Action
Alliance for Suicide Prevention . This week, the Research
Prioritization Task Force (RPTF) released A Prioritized
Research Agenda for Suicide Prevention: An Action Plan to Save Lives.
The stated goal of the Research Agenda is to
reduce suicides by 20 percent in five years and 40 percent in the next ten
(assuming all recommendations are fully implemented). The Research Agenda
bases its recommendations on the impact of currently known interventions and
the potential number of suicide attempts and deaths prevented. For instance, it
was estimated that in 2010 there were 735 suicides from motor vehicle carbon
monoxide inhalation.3 One model
illustrated the hypothetical effect of shut-off devices in cars linked to
carbon monoxide sensors, a technology that could be inexpensive per vehicle and
is currently feasible. The results suggest that installing devices the way we
install seat belts could prevent most suicides from carbon monoxide poisoning
in automobiles.
What are we doing to jumpstart this agenda? Two new
initiatives will focus on priorities of the Research Agenda. First, NIH
recently announced funding
opportunities calling for research on violence with particular focus on firearm
violence. This call for proposals was developed in response to the Presidential
memorandum in January 2013 directing science agencies within the U.S.
Department of Health and Human Services to fund research into the causes of
firearm violence and ways to prevent it. The resulting research will help us
understand the risk factors for firearm violence and prevention opportunities,
directed at self as well as others.
In 2010, suicide was the third leading cause of death for
adolescents. It remains a challenge to predict individual risk, and once a
young person screens positive for suicide risk, there are few, if any,
strategies to guide matching of individuals to the appropriate intervention. As
a second initiative, NIMH released a request for
applications to support research that addresses both issues:
developing and testing screening approaches for use in emergency departments
(EDs) to identify children and adolescents at risk for suicide; and developing
methods to help assign youth who screen positive to appropriate interventions.
Given the numbers of young people who may be at risk, and the high number of
them who visit the ED, developing effective screening and assessment approaches
to gauge the level of risk can give providers the tools they need to better use
limited resources.
A friend who lost his son to suicide told me that every
suicide has at least 11 victims: the person who dies and at least ten others
who will never be the same. This is a problem that sooner or later,
unfortunately, touches us all. Developing the Research Agenda was a
3-year effort by the RPTF, chaired by Phillip Satow, chair of the board at the Jed Foundation , and myself. The
RPTF called on more than 60 national and international research experts and
more than 700 individuals representing stakeholders in this research to
identify priorities. We believe the Research Agenda gives us a roadmap
to save lives.
References
1 Centers for Disease Control and Prevention, Web-based Injury Statistics
Query and Reporting System, http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html .
2 The Joint Commission. Sentinel Event Alert. Issue 46, November 17,
2010. http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html .
3 National Action Alliance for Suicide Prevention: Research Prioritization
Task Force. (2014). A prioritized research agenda for suicide prevention: An
action plan to save lives. Rockville, MD: National Institute of Mental
Health and the Research Prioritization Task Force.
___________________
This post was originally posted on the NIMH Director's Blog.
Thursday, October 10, 2013
Substance Abuse Prevention is Suicide Prevention
By Action Alliance Executive Secretary David Litts & Colleen Carr
Many of the factors that increase the risk for substance abuse, such as traumatic experiences, also increase the risk for suicidal thoughts and behaviors,[iii],[iv] and substance abuse, like mental health problems, is linked with a several-fold increase in suicide risk.[v],[vi]
There is hope, however: Prevention works, treatment is effective, and recovery is possible. Life skills that support effective problem-solving and emotional regulation, connections with positive friends and family members, and social support can protect individuals from both substance abuse and suicide. Treatment and support are important precursors for recovery from substance abuse as well as recovery from suicidal thoughts.[vii],[viii]
In September 2012, a newly revised National Strategy for Suicide Prevention (NSSP) was released by the National Action Alliance for Suicide Prevention (Action Alliance) in conjunction with the Office of the Surgeon General. The Action Alliance is a public-private partnership, jointly launched in 2010 by the Secretaries of Health and Human Services and Defense, envisioning a Nation free from the tragic experience of suicide. The connection between suicide prevention and the prevention and treatment of substance abuse is either implicit or explicit in each of the 13 goals of the NSSP, as it should be. Recognizing this, the NSSP calls for several actions, including:
[i] Centers for Disease Control and Prevention. National Vital Statistics System. 2010 Multiple Cause of Death File. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2012.
[ii] www.samhsa.gov/data/2k13/DAWN2k10ED/DAWN2k10ED.htm#6.2
[iii] Dube, S, Felitti V et all. (2003). Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study. Pediatrics, Vol. 111 No. 3.
[iv] Afifi T, Murray W, et al. (2008) Population Attributable Fractions of Psychiatric Disorders and Suicide Ideation and Attempts Associated With Adverse Childhood Experiences. American Journal of Public Health 2008, Voi 98, No. 5.
[v] Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbest NT, Caine ED (1996). Relationships of age and axis I diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153(8): 1001-1008.
[vi] Moscicki EK (2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention.Clinical Neuroscience Research, 1, 310-323.
[vii] Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive Therapy for the Prevention of Suicide Attempts: A Randomized Controlled Trial. JAMA: Journal of the American Medical Association, 294(5), 563-570.
[viii] Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder. Archives of General Psychiatry, 63(7), 757-766.
This blog entry is cross-posted on the white house website.
When we prevent or successfully treat substance abuse, we prevent suicides. There is a powerful connection between the missions of the substance abuse prevention and treatment communities and the suicide prevention community – and much to be gained when these groups come together around their common goals.
Drug poisoning deaths have increased 120 percent in recent years – from 17,415 in 2000 to 38,329 in 2010. The majority (58 percent) of the drug deaths involved pharmaceuticals, and 75 percent of those deaths involved prescription pain relievers.[i] In 2010, U.S. emergency departments treated 202,000 suicide attempts in which prescription drugs were used as the means, 33,000 of which were narcotic pain relievers.[ii]
The suicide and substance abuse prevention fields need to align their efforts to promote healthy individuals and healthy communities.Drug poisoning deaths have increased 120 percent in recent years – from 17,415 in 2000 to 38,329 in 2010. The majority (58 percent) of the drug deaths involved pharmaceuticals, and 75 percent of those deaths involved prescription pain relievers.[i] In 2010, U.S. emergency departments treated 202,000 suicide attempts in which prescription drugs were used as the means, 33,000 of which were narcotic pain relievers.[ii]
Many of the factors that increase the risk for substance abuse, such as traumatic experiences, also increase the risk for suicidal thoughts and behaviors,[iii],[iv] and substance abuse, like mental health problems, is linked with a several-fold increase in suicide risk.[v],[vi]
There is hope, however: Prevention works, treatment is effective, and recovery is possible. Life skills that support effective problem-solving and emotional regulation, connections with positive friends and family members, and social support can protect individuals from both substance abuse and suicide. Treatment and support are important precursors for recovery from substance abuse as well as recovery from suicidal thoughts.[vii],[viii]
In September 2012, a newly revised National Strategy for Suicide Prevention (NSSP) was released by the National Action Alliance for Suicide Prevention (Action Alliance) in conjunction with the Office of the Surgeon General. The Action Alliance is a public-private partnership, jointly launched in 2010 by the Secretaries of Health and Human Services and Defense, envisioning a Nation free from the tragic experience of suicide. The connection between suicide prevention and the prevention and treatment of substance abuse is either implicit or explicit in each of the 13 goals of the NSSP, as it should be. Recognizing this, the NSSP calls for several actions, including:
- Train staff in substance abuse treatment settings to ask their clients and patients directly and in a non-judgmental way whether they are having thoughts of suicide or think things would be better if they were dead. Ask on intake and periodically throughout the course of treatment, and ask in a way that opens the door for a truthful response.
- Work with individuals, families and other social groups, and communities to reduce access to drugs, especially access to lethal quantities of drugs among individuals at increased risk for suicide. This includes reducing stocks of medications kept in the home, locking up commonly abused medications, and encouraging the proper disposal of unused and unneeded prescription drugs, a key component of the 2013 National Drug Control Strategy.
[i] Centers for Disease Control and Prevention. National Vital Statistics System. 2010 Multiple Cause of Death File. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2012.
[ii] www.samhsa.gov/data/2k13/DAWN2k10ED/DAWN2k10ED.htm#6.2
[iii] Dube, S, Felitti V et all. (2003). Childhood Abuse, Neglect, and Household Dysfunction and the Risk of Illicit Drug Use: The Adverse Childhood Experiences Study. Pediatrics, Vol. 111 No. 3.
[iv] Afifi T, Murray W, et al. (2008) Population Attributable Fractions of Psychiatric Disorders and Suicide Ideation and Attempts Associated With Adverse Childhood Experiences. American Journal of Public Health 2008, Voi 98, No. 5.
[v] Conwell Y, Duberstein PR, Cox C, Herrmann JH, Forbest NT, Caine ED (1996). Relationships of age and axis I diagnoses in victims of completed suicide: A psychological autopsy study. American Journal of Psychiatry, 153(8): 1001-1008.
[vi] Moscicki EK (2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention.Clinical Neuroscience Research, 1, 310-323.
[vii] Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive Therapy for the Prevention of Suicide Attempts: A Randomized Controlled Trial. JAMA: Journal of the American Medical Association, 294(5), 563-570.
[viii] Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-Year Randomized Controlled Trial and Follow-up of Dialectical Behavior Therapy vs Therapy by Experts for Suicidal Behaviors and Borderline Personality Disorder. Archives of General Psychiatry, 63(7), 757-766.
This blog entry is cross-posted on the white house website.
Thursday, February 7, 2013
Health Care Reform: The Opportunity for Suicide Prevention
By Michael Hogan, Ph.D., Independent Advisor and Consultant at Hogan Health Solutions LLC, Action Alliance Executive Committee member, and co-lead of the Clinical Care and Intervention Task Force
When
the Action Alliance selected the integration of suicide prevention into health
care reform as one of its four national priorities stemming from the National Strategy for Suicide Prevention, it was still unclear as to what the
Supreme Court’s response would be to legal challenges involving the Affordable
Care Act. Either way, the Action Alliance felt that major changes to the health
care system were going to occur. Should we not strive to use the momentum of
reform to better focus health care on people at risk for suicide?
Most
mental health professionals and advocates agree that the health and behavioral
health care system in the US does not currently meet the needs of patients
struggling with suicidal behavior – in sum, “suicide care” is inadequate. Health
care reform presents the most significant opportunity in a generation to make the
health care system more responsive to individuals who are at risk for suicide
or who are engaging in suicidal behavior. It’s an opportunity to save lives,
contributing to the realization of the Action Alliance’s goal of saving 20,000
lives in five years.
The
US Centers for Medicare and Medicaid Services (CMS) has the lead responsibility of interpreting and implementing the Affordable Care Act of 2010, and the
Substance Abuse and Mental Health Services Administration (SAMHSA) has the lead
on behavioral health issues. For this reason, the Action Alliance has been working
with SAMHSA Administrator Pam Hyde to engage senior CMS leadership in a
conversation about the integration of suicide prevention into health care
reform over the last year and a half.
Health
care reform aims to deliver what former CMS Administrator Don Berwick called
the Triple Aim: better health for populations, better care for individuals, and
reduced costs to society. Transforming health systems to prevent suicide and
improve suicide care addresses all of these goals.
By
identifying patients at risk for suicide early, risks can be reduced and effective
treatment can be delivered. By providing early and effective treatment in a
behavioral health setting or in a collaborative care setting where primary care
and behavioral health care are integrated, we can save lives and prevent some suicide
attempts that result in costly emergency medical expenses.
We
know that people admitted to hospital or emergency department care with suicidal
behavior remain at high risk when they leave. And we know that if we ensure a
patient receives continuity of care through the discharge and out-patient care
engagement process, we can reduce expensive re-hospitalizations and suicides.
We have also learned that when health systems focus on safety and suicide care, the results are far better than those achieved through piecemeal approaches. One of the keys must be leadership among health plans and systems. They can encourage better screening for depression and suicidality, delivery of effective, evidence-based treatment and continuous care to patients who are at risk. Health plans and payers must transition from paying for the quantity of episodic services to paying for better integrated care that will change the health outcomes of populations.
I have been privileged to meet with the
Action Alliance Co-Chairs, SAMHSA Administrator Hyde, CMS Administrators (Acting
Administrator Don Berwick in 2011, and current Acting Administrator Marilyn
Tavenner in 2012), my fellow Action Alliance Executive Committee member Paul
Schyve, and the Action Alliance Secretariat on several occasions to discuss
areas of health care reform implementation that are relevant and critical to
suicide prevention. The Action Alliance has also submitted public comments in
response to CMS’s efforts to implement electronic health record technology. In
all of our interactions, we have focused on three domains: promoting early identification of those at
risk for suicide, the delivery of effective treatment for suicidal behavior,
and the provision of the follow-up care for those at risk as they transition
from one setting of care to another. Later this year, the Suicide
Prevention Resource Center will partner with The National Council for Community
Behavioral Healthcare to “go live” with a website providing tools for providers
to take these steps. These improvements within an evolving health system are
the key targets for getting us to that goal of saving 20,000 lives in five
years.
What do you think? How would you like to see suicide
prevention integrated into health care reform? Please comment and share your
ideas below.
Monday, September 17, 2012
A New National Strategy...Now What?
By Executive Committee member and co-lead of the National Strategy for Suicide Prevention Task Force Jerry Reed & Suicide Prevention Resource Center's Elly Stout
This year we celebrate Suicide Prevention Week with revitalized purpose as we welcome a new National Strategy for Suicide Prevention. For the first time since 2001, we have an updated Strategy to guide the nation, drawing on eleven years of growth and advances in our field.
The National Strategy is a call to action to guide suicide prevention in the United States over the next ten years. It outlines four strategic directions, with 13 goals and 60 objectives that are meant to work together across all levels of government - and with various local and community programs and activities - to reduce the toll of suicide in the nation. Some of these objectives will best be advanced at the national level, while others will be most appropriately handled at state and local levels. At all levels, partners from different sectors should be involved, be they public or private.
This new National Strategy reminds us all that we all have a role to play in advancing suicide prevention efforts, and recommends specific ways we can get involved. If you are part of a state or local suicide prevention group or coalition, you may be wondering what the new strategy means for you.
As the Strategy is launched, many will consider taking steps to update their own state or local suicide prevention plans. Our hope is that you will use the revised Strategy as a guide and consider it a key resource that should be an important part of your local strategic planning efforts. At the same time, we want to caution that not every recommendation in the Strategy should be applied literally in every state and community.
The National Strategy offers a wonderful menu of options, but it’s up to state and local groups to prioritize what will work best and reach those most at risk in their communities. And the way to figure out what are the best options is simple: Start with your data. Only by looking at data on suicide risk (both quantitative and qualitative) in your community can you focus on the areas of greatest need and effectively pursue programs that reduce suicidal behaviors and save lives.
Based on local data, what groups are at highest risk for suicide in your community? What are the factors that put them at risk or may be protective? What approaches would be best to pursue? Without the data to give you answers to these questions, you really can’t know who is most at risk in your community and what strategies have the best chance of saving lives.
Go ask your state epidemiologist; see if your state has a web-based query system; look at your NVDRS data; use NSDUH, YRBSS, and WISQARS. And once you understand which groups are most at risk, or what approaches would be helpful, look to our new, improved National Strategy to find strategies that can save lives in your community.
This blog post is cross posted from the Suicide Prevention Resource Center.
This year we celebrate Suicide Prevention Week with revitalized purpose as we welcome a new National Strategy for Suicide Prevention. For the first time since 2001, we have an updated Strategy to guide the nation, drawing on eleven years of growth and advances in our field.
The National Strategy is a call to action to guide suicide prevention in the United States over the next ten years. It outlines four strategic directions, with 13 goals and 60 objectives that are meant to work together across all levels of government - and with various local and community programs and activities - to reduce the toll of suicide in the nation. Some of these objectives will best be advanced at the national level, while others will be most appropriately handled at state and local levels. At all levels, partners from different sectors should be involved, be they public or private.
This new National Strategy reminds us all that we all have a role to play in advancing suicide prevention efforts, and recommends specific ways we can get involved. If you are part of a state or local suicide prevention group or coalition, you may be wondering what the new strategy means for you.
As the Strategy is launched, many will consider taking steps to update their own state or local suicide prevention plans. Our hope is that you will use the revised Strategy as a guide and consider it a key resource that should be an important part of your local strategic planning efforts. At the same time, we want to caution that not every recommendation in the Strategy should be applied literally in every state and community.
The National Strategy offers a wonderful menu of options, but it’s up to state and local groups to prioritize what will work best and reach those most at risk in their communities. And the way to figure out what are the best options is simple: Start with your data. Only by looking at data on suicide risk (both quantitative and qualitative) in your community can you focus on the areas of greatest need and effectively pursue programs that reduce suicidal behaviors and save lives.
Based on local data, what groups are at highest risk for suicide in your community? What are the factors that put them at risk or may be protective? What approaches would be best to pursue? Without the data to give you answers to these questions, you really can’t know who is most at risk in your community and what strategies have the best chance of saving lives.
This blog post is cross posted from the Suicide Prevention Resource Center.
Tuesday, January 31, 2012
Protecting Life in Indian Country
As the Action Alliance carries out its important work of advancing our National Strategy for Suicide Prevention, I believe that we can make a significant difference in the lives of many. For American Indian and Alaska Native communities, this assistance is especially needed.
Bringing awareness to this issue is of utmost importance and for this reason the Indian Health Service, Bureau of Indian Affairs, Bureau of Indian Education, and Substance Abuse and Mental Health Services Administration recently hosted two Action Summits for Suicide Prevention. The first Summit was held August 2011, in Scottsdale, Arizona and the second Summit was held October 2011 in Anchorage, Alaska.
 |
Yvette Roubideaux, MD, MPH Director Indian Health Service United States Department of Health & Human Services National Action Alliance Executive Committee Member |
The Summits brought together nationally recognized speakers, behavioral health providers, tribal leaders, health care providers, law enforcement, first responders, school personnel, and many others. In total, more than 1,000 people attended. During this time, we worked to develop and strengthen new and existing collaborations, gather information on best and promising practices, and collect information on the most up-to-date research on suicide and substance abuse prevention, intervention, and aftercare. Most importantly, the Summits provided an opportunity to share personal experiences in addressing suicide and substance abuse in Indian Country.
In order to bring about real change, numerous parties need to be involved and dedicated. The Summits focused on the importance of collaboration among tribal, federal, state, and community- and program-level leadership to promote American Indian and Alaska Native behavioral health. This work will pave the way for new partnerships and help advance the mission of the Action Alliance.
The Action Alliance American Indian and Alaska Native Task Force has a goal. That goal is to implement suicide prevention strategies to reduce the rate of suicide in American Indian and Alaska Native communities. We are working hard to ensure that we reach our goal.
As a member of the Rosebud Sioux tribe, reducing suicide in Indian country is very important to me and I have dedicated my career to improving American Indian health care. I hope that my leadership of the American Indian and Alaska Native Task Force and membership on the Action Alliance’s Executive Committee will advance suicide prevention in our nation and I work every day to do my part in ensuring that this goal is reached.
Sunday, May 1, 2011
What is the Action Alliance?
The National Action Alliance for Suicide Prevention is the public-private partnership advancing the National Strategy for Suicide Prevention. Our vision is a nation free from the tragic experience of suicide and our mission is to advance the National Strategy for Suicide Prevention (NSSP) by:
Suicide is a major public health issue, taking life without regard to age, income, education, social standing, race, or gender. Overall, suicide is the 10th leading cause of death for all Americans, the 2nd leading cause of death for adults ages 25-34, and the 3rd leading cause of death for youth ages 15-24. The legacy of suicide continues long after the death, impacting bereaved loved ones and communities. State and local prevention efforts are having a positive impact, as shown by decreasing suicide rates among teenage and elder males, two of the hardest hit groups. Suicide is a serious and preventable public health problem and the time to change these statistics is now.
- Championing suicide prevention as a national priority
- Catalyzing efforts to implement high priority objectives of the NSSP
- Cultivating the resources needed to sustain progress
Suicide is a major public health issue, taking life without regard to age, income, education, social standing, race, or gender. Overall, suicide is the 10th leading cause of death for all Americans, the 2nd leading cause of death for adults ages 25-34, and the 3rd leading cause of death for youth ages 15-24. The legacy of suicide continues long after the death, impacting bereaved loved ones and communities. State and local prevention efforts are having a positive impact, as shown by decreasing suicide rates among teenage and elder males, two of the hardest hit groups. Suicide is a serious and preventable public health problem and the time to change these statistics is now.
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