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National Strategy for Suicide Prevention:
Goals and Objectives for Action

GOAL 2:
Develop Broad-Based Support
for Suicide Prevention

Because there are many paths to suicide, prevention must address psychological, biological, and social factors if it is to be effective. Collaboration across a broad spectrum of agencies, institutions, and groups–from schools to faith-based organizations to health care associations– is a way to ensure that prevention efforts are comprehensive. Such collaboration can also generate greater and more effective attention to suicide prevention than can these groups working alone. Public/private partnerships that evolve from collaboration blend resources and build upon each group's strengths. Broad-based support for suicide prevention may also lead to additional funding, through governmental programs as well as private philanthropy and to the incorporation of suicide prevention activities into the mission of organizations that have not previously addressed it. In 1993, the United Nations/World Health Organization identified broad-based collaborative support as a key element in developing and implementing national suicide prevention strategies (UN/WHO, 1996).

In the last five years, a new collaborative effort has been forged in the fight against suicide. The 1998 National Suicide Prevention Conference brought several Federal agencies together with private groups to focus attention on suicide prevention. This conference engendered renewed enthusiasm for suicide prevention and increased collaboration among public health and mental health agencies on suicide prevention activities (see Foreword, Public efforts leading to the Goals and Objectives for Action).

An indication that the Nation has begun to recognize the severity of the problem of suicide is an increase in the numbers of Members of Congress who have begun to focus attention on the topic. Another is the expansion or formation of organizations focused solely on suicide prevention. For example, the American Association of Suicidology has broadened its membership considerably and now has approximately 900 members. In 1996, the Suicide Prevention Advocacy Network was formed, a grassroots organization made up of survivors of suicide, attempters of suicide, community activists, and health and mental health clinicians. The American Foundation for Suicide Prevention, established in 1987, is a private organization that supports research on suicide prevention and disseminates information on effective strategies. In 2000, the National Council for Suicide Prevention was formed, representing a total of 12 advocacy, survivor and research organizations, each with a primary focus on suicide prevention. In short, support for suicide prevention is growing, but much work still remains to be done to engage the public fully.

The objectives established for this goal are focused on developing collective leadership and on increasing the number of groups working to prevent suicide. They will help ensure that suicide prevention is better understood and that organizational support exists for implementing prevention activities. The objectives also provide a management structure for the NSSP, a key factor in its success.

The Federal government has a major role to play in suicide prevention, and several Federal agencies have responsibilities related to suicide prevention, suicidal behavior, and response to suicide attempts, as described in Appendix D.

While several Federal agencies are active in suicide prevention efforts, improved planning and coordination can ensure that resources are used most effectively. Knowledge and resources can also enhance the prevention efforts of each agency. With Federal agencies working together, the goals of the National Strategy can be embedded in their ongoing work and suicide prevention efforts can become integrated into the spectrum of an agency's mandates and activities. The NSSP Federal Steering Group, established in 2000 by the Secretary of Health and Human Services, is already facilitating such coordination, and thus this objective is to some degree already met. In addition to the Office of the Surgeon General and the U.S. Public Health Service Regional Health Administrators, its membership includes several agencies of the Department of Health and Human Services–the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration. This membership is augmented by liaisons from eleven other Federal agencies (see Appendix D).

Leadership and collaboration are the keys to success of the National Strategy. The establishment of a public/private coordinating body will stimulate the requisite national attention to the issue. Such a body will help to ensure that suicide prevention is perceived as a national problem and the NSSP as a national plan. The partnership will help establish momentum for the plan and will provide continuity over time and legitimacy through the involvement of key groups. And finally, the coordinating body will oversee the implementation of the National Strategy.

To make suicide prevention efforts more effective and to leverage resources, suicide prevention must be integrated into programs and activities that already exist and included in the agendas of communities and national groups. Some national advocacy groups and some communities attempt to address many problems simultaneously, but have not considered or included suicide among these issues. It is often possible to target several health or social problems with one intervention, particularly since some risk factors put population groups at risk for more than one problem at the same time. Therefore, an intervention that targets one or more risk or protective factors has the potential to effect change in more than one identified problem. For example, the suicide rate has risen steeply over the last two decades for African-American youth, a group with a high risk for other health and social problems. Programs focused on enhancing educational and occupation-al opportunities for African-American youth may contribute to feelings of hope and self-assurance, and as a by-product reduce suicide. However, by consciously integrating program elements that address suicide prevention more directly (for example, encouraging help-seeking for emotional distress), a program may be even more effective overall.

While many faith groups have already taken strong stands on suicide prevention, others have not. And yet the statements and positions of faith groups are often key to influencing public opinion. By adopting institutional policies on suicide, faith groups can help to de-stigmatize mental illness and alcohol and substance use problems and change the perception of suicide from something that is shameful to a problem that can be prevented. Faith groups can also assist in suicide prevention by helping their members identify risk factors, encouraging treatment for depression, sustaining protective factors and offering support and guidance to individuals during stressful times. For instance, faith-based organizations are well positioned to provide community guidance on ways to support family members who survive the loss of a loved one to suicide, while avoiding the excessive memorializing of those who have died by suicide that may lead to suicide contagion. A few faith groups have developed statements or "messages" on suicide prevention, which provide guidance to members on the scope of suicide and on how individuals can help prevent it (Evangelical Lutheran Church in America, 1999).

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