The National Strategy for
Suicide Prevention:
Everyone Has a Role
Richard McKeon Ph.D.
Can national strategies reduce
suicide rates?
• Yes, but it requires a sustained,
comprehensive approach in which everyone
has a role.
• Implementation of national strategies/
national efforts have led to reductions in
England and Taiwan.
• Organizations as different as the U.S. Air Force
and the Henry Ford Health System have also
shown reductions.
International Efforts
• England—Reduction in suicides in
communities that implemented
• Community crisis teams, proactive outreach
• Follow-up within 7 days of IPU discharge
• Training of clinical staff at least every 3 years
• Dual diagnosis policies
• Taiwan—Follow-up after suicide attempts led
to 63% reduction in suicides.
The Air Force Did It
MH
Henry Ford Health System
Also Did It
MH
Key Issues
• Integrate and coordinate suicide prevention
activities across multiple sectors and settings.
• Comprehensive, lifespan approach.
• Data-driven efforts to continuously improve.
• Both public and private sectors.
• Healthcare providers, educators, workplaces,
faith-based entities, and community-based
organizations all need to be involved.
Tough Realities
8
• ~30 percent of deaths by suicide
involved alcohol intoxication – BAC
at or above legal limit
Tough Realities
9
2005-2009: 55%↑ in
emergency department visits
for drug related suicide
attempts by men 21 to 34
2005-2009: 49% ↑ in
emergency department visits
for drug related suicide
attempts by women 50+
Every year > 650,000 persons receive treatment
in emergency rooms following suicide attempts
What if we targeted these groups for
suicide prevention programs?
Full time Employed
(18+)
Treated in ER for
any reason in past
year (18+)
Military Veterans
(18+)
Adults (18 +) on
Medicaid/CHIP
Full time College
Students (18+)
Adults (18+) on
Probation or
Parole
Adults in
Substance Use
Treatment
Estimated Number
in Population
(Number in
Thousands)
Past year Suicidal
Ideation
(Number in
Thousands)
Past Year Suicide
Attempt
(Number in
Thousands)
Pat year SMI and
suicidal ideation
(Number in
Thousands)
Past year SMI and
Suicide attempt
(Number in
Thousands)
118,225
3,678
351
1,213
149
57,977
3,839
686
1,686
403
24,356
804
74
276
44
18,629
1,383
270
644
164
14,612
785
108
312
64
5,581
585
161
285
106
2,292
395
106
238
80
Data Source: SAMHSA , Center for Behavioral Health Statistics and Quality, National Survey on Drug use And Health (NSDUH), 2008 and 2009
Key Issues
• Goal 7– Provide training to community and
clinical service providers on the prevention of
suicide and related behaviors.
• Community groups, mental health, and
substance abuse providers.
• Recognizing the warning signs for suicide and
actions to take in response.
• Train in evidenced-based practices.
BH Workforce Survey (16 Questions)
Role
Counselor
Social Worker
Physician
Nurse
Case Manager
Para-professionals
Certified Peer Staff
Administrator
Support Staff
22,337
#
2,421
2,361
416
1,371
3,312
826
479
2,640
3,409
SMI Suicide Rate
vs. General
Population
Total Responses
6,816
1,123
2,507
6,292
1,562
3,802
One/Three
Supports
Training
Skills
I have the _________ to engage and assist those who are suicidal.
39% 44% 30% 53%
Endorsed Don’t Know, Disagree, or Completely Disagree
Over 6,000 report a patient has
died by suicide (27%).
Once
• 3,314 / 15%
More than
once
• 2,792 / 13%
Suicide Prevention as a Core
Component of Health Care
• What does it look like?
• The clinical workforce is routinely trained in suicide risk assessment,
management, and treatment.
• Accrediting and certifying bodies have standards and guidelines
related to suicide prevention.
• Continuity of care during high risk transition times is assured.
• Deaths by suicide and non-fatal suicide attempts are routinely
monitored and reviewed to help guide suicide prevention efforts.
• Continuous quality improvement efforts focused on suicide
prevention are conducted.
• VA and Joint Commission have made major efforts.
“For many years suicide prevention has not been
informed by people who have been there. Peers
who have experienced the agony and decisionmaking can provide support that can be magic.”
- Eduardo Vega
Mental Health America of San Francisco
National Suicide Prevention Lifeline
1-800-273-TALK
• Answered over 800,000 calls in 2012.
• 161 local crisis centers—your partners
in suicide prevention.
• In response to evaluation findings, created the
Crisis Center Follow-up Grants, developed risk
assessment standards, and guidelines for
callers at imminent risk.
• Crisis Chat service can be accessed through
Lifeline website.
Preventing Suicide: A Toolkit for High Schools
16
• We now have many
resources. We need to
utilize them and make
them even better.
To Live to See the Great Day that Dawns
17
TIP 50
TIP 50: Addressing Suicidal Thoughts and Behaviors in Substance
Abuse Treatment
• High prevalence of suicidal thoughts and attempts among
persons with SA problems who are in treatment.
• TIP 50 helps
– SA counselors work with adult clients who may be suicidal
– Clinical supervisors and administrators
• Free at: http://store.samhsa.gov/product/SMA09-4381
• Training video: SAMHSA YouTube channel
• SPRC Webinar:
http://www.sprc.org/traininginstitute/disc_series/disc_22.asp\
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Everyone Has a Role - National Action Alliance for Suicide Prevention