Advancing Affordable Care

Key to preventing suicide is access to care for mental illness and addiction. Yet for scores of uninsured and underinsured Americans, behavioral health services are inaccessible. For those with insurance coverage, inequity in reimbursement for mental versus physical illness reflects a stigma that continues to dog mental illness. This inequity is addressed in the Federal Mental Health Parity Act of 2008, yet more needs to be done so that those at greatest risk for suicide can access the health care they desperately need.

Strengthening Clinical Core Competencies

Get a suicidal person to a doctor. This seems appropriate action until you consider that many clinicians are not trained in assessing and managing suicidality in their patients. Given that suicide is the most frequent chief complaint for admission to inpatient psychiatric care, a profound need exists to enhance clinical knowledge and treatment standards for suicidal patients. We have a field of evidence-based, scientific knowledge and intervention protocols on prevention of suicide - but it's not being communicated to clinicians. This needs to change.

Developing and Disseminating Best Practices

A substantial gap exists between what is known about preventing suicide, and what is actually being done. It is no longer accurate to argue that suicide can never be prevented. Our 16th U.S. Surgeon General David Satcher notes that suicide is a preventable public health threat, and our National Strategy for Suicide Prevention reflects this position. What's lacking are the awareness and systems to deliver best-practice and evidence-based interventions and prevention programs to a far wider group of stakeholders.

Countering Stigma

A "culture of stigma" is a significant contributing factor to completed suicides in our nation. Stigma is associated with mental illness, seeking treatment, and even admitting that you are struggling emotionally. This stigma can create shame, isolation, and pose barriers to seeking services, and this can be life threatening. Awareness and education are key to addressing stigma, as is enhanced understanding among policymakers that those at risk for suicide may be among our best and brightest - lives well worth saving.

Enhancing Surveillance

How many Americans die by suicide each year? We don't really know. Reported suicides in our nation numbered 33,300 in 2006, but that doesn't count intentional deaths not ruled as suicides - such as single motor vehicle accidents and drug overdoses. Enhancing surveillance of suicide deaths means collecting death data to define its scope, and this is vital to prevention. That's because research, clinical service delivery systems and other resource allocation are based on need, as identified in annual U.S. mortality data. So communication with policymakers to strengthen our National Violent Death Reporting System vital.

Focusing on High-Risk Populations

Mortality data and research have shown risk for suicide is highest among certain populations - Caucasian men over age 65, LGBTQ youths, American Indian and Alaskan Native youths ages 15-24, Americans residing in rural communities, and other groups. The public-health approach called for in our National Strategy for Suicide Prevention notes the importance of selective interventions, designed especially for certain sub-groups at particular risk for suicide. So it's vital that people who interact with these at-risk sub-groups are aware of potential for suicide, and this awareness can be enhanced with communication.

Intervening Early

Early detection and treatment can enhance survival rates many illnesses - including mental illnesses. Research shows that approximately 90 percent of those dying by suicide have a mental illness. So intervening early with those at risk for suicide - based on population group, genetic risk, environmental factors - is key to saving lives. Those in a position to intervene early with at-risk individuals - such as teachers, family members, law enforcement and clergy - need to know how to recognize those vulnerable to suicide, and what to do to help them.