Making Connections, Preventing Suicide
How can we prevent suicide among those at greatest risk? Part 1.
By Katie Deal and Sarah Wonders
Atlas Research is working with prevention leaders to understand and prevent the complex and heartbreaking issue of suicide. Doing so involves helping them understand the scope of suicidal behavior and thoughts, what impacts suicide risk, and what can be done to prevent suicide. It also includes equipping them with the skills and resources to effectively communicate about suicide and carry out prevention work in their systems and settings.
While this work can seem daunting at times, we take heart in the advancements being made in suicide prevention and are grateful to work on and have discussion on this important issue.
Understanding Suicide and Health Disparities
Understanding suicide as a public health issue begins with the data. Suicide has been among the top 12 leading causes of death for nearly 40 years, and suicide rates have increased substantially over the past two decades. In 2019, 12 million American adults seriously thought about suicide, 3.5 million made a suicide plan, and 1.4 million attempted suicide (SAMHSA). Further digging into the data about suicide, suicide attempts, and suicidal thoughts reveals that rates vary by population and setting.
Compared to the general population, the risk of suicide is higher among communities of color, including American Indian and Alaskan Natives; LGBTQ+ people; older adults, especially white males; Veterans; populations living in concentrated poverty; and rural populations.
Such disparities have continued or increased during the COVID-19 pandemic. For example, the first study to characterize suicide trends by race/ethnicity during COVID-19 showed that suicide rates among African Americans doubled during Spring 2020 compared to the same period in previous years. Emergency department visits for suicide attempts have increased among adolescents and young adults aged 12–25 years (CDC). The Centers for Disease Control and Prevention published data in August 2020 that showed an increase in reported thoughts of suicide among minority racial/ethnic groups, young adults aged 18–24 years, unpaid caregivers for adults, and essential workers, and that thoughts of suicide are higher among males than among females.
Why do these disparities exist? The Prevention Institute states that health outcomes such as suicide “have been produced by historical and current-day policies, laws, practices, and procedures that shape the determinants of health.” Social determinants of health, such as employment/underemployment, housing, discrimination, and literacy, have serious physical and mental health consequences that impact suicide-related outcomes.
Understanding the data on health disparities and equity at the national, tribal, state, and local level help us identify risk and protective factors that contribute to suicidal thoughts and behavior and offer insight in how to develop prevention programs and resources.
Data also shows that suicide is preventable, and that its prevention not only helps individuals and families, “but also benefits the well-being of communities, the health-care system and society at large” (WHO). So what does suicide prevention actually look like?
Bending the Curve
A lot has been invested over the last few decades to build the suicide prevention infrastructure in the US, including developing multi-sector collaborations and strategic plans at the national, tribal, state, and local community levels; financing suicide prevention research and prevention grants; expanding and training the suicide prevention workforce; developing health communications campaigns to change attitudes, beliefs, and cultural norms; and evaluating prevention policies and programs to build an evidence base of what works or is likely to be effective.
As this infrastructure has been strengthened, we have also seen the importance of addressing the factors that increase and decrease suicide risk on the individual, relationship, community, and environmental levels. This means combating risk factors such as trauma, mental health and substance misuse problems, social isolation, poverty, and stigma about help-seeking behavior, as well as strengthening protective factors such as coping and problem-solving skills, messaging about hope and resilience, supportive relationships with providers and community, a support system of family and/or friends, and limited access to lethal means of suicide (CDC). And we know that comprehensive strategies that address multiple risk and protective factors at various levels of influence and that are advanced via multisector collaboration are essential to achieving suicide reduction (WHO, CDC).
What can be done to build upon this infrastructure, adopt an upstream public health approach to prevention, and bend the curve in the suicide data? We will address these questions in our next post.
If You Know Someone in Crisis
Call the National Suicide Prevention Lifeline (Lifeline) at 1–800–273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website.
The Military/Veterans Crisis Line connects military Service members and Veterans in crisis, as well as their family members and friends, with qualified US Department of Veteran’s Affairs (VA) responders through a confidential toll-free hotline, online chat, or text messaging service. Dial 1–800–273–8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder. You can also start a confidential online chat session at Veterans Crisis Chat.
Atlas Research’s Health Disparities Working Group is releasing a new series identifying and providing solutions to the complex challenges that underserved Americans face. We look forward to engaging with our readers and driving the conversation on topics such as mental health, Veterans’ health, homelessness, maternal health, economic disparities, racial justice, and more. Opinions expressed are that of the authors, and do not necessarily reflect Atlas’ position.
