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Post by Former NIMH Director Thomas Insel: Strategy on Suicide Prevention

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Today, on World Suicide Prevention Awareness Day, an updated National Strategy for Suicide Prevention is being released amidst a public health landscape that has changed thanks in part to the focus brought to suicide by the first national strategy issued 11 years ago. Since the first version was issued, the Suicide Prevention Lifeline was established, Federal and State legislation has been passed that advances suicide prevention planning and programming, and the Suicide Prevention Resource Center was established, among other efforts.

At the same time, the updated national strategy is a declaration that we can't let up the pressure on the goal of reducing the suicide rate in this country. As I mentioned in a recent blog, the Centers for Disease Control and Prevention (CDC) report over 36,000 suicides annually. This translates to roughly four suicides per hour in this country, greater than the number of homicide or motor vehicle related fatalities. Suicide occurs in all parts of our society and in all regions, affecting people of all ages. No group is immune but there are some groups at greater risk. For instance, men are four times more likely than women to die of suicide and older men have been an often overlooked group with a particularly high suicide rate.

The new national strategy reemphasizes the importance of research that can help us develop effective interventions. Key is understanding how and where people at risk for suicide seek care. Surveillance data will help focus efforts for providing effective emergency and follow up care. A task force of the National Action Alliance for Suicide Prevention is developing a more detailed research agenda based on consultation with stakeholders, a literature review, and analysis of current research. This agenda, anticipated in early 2013, pledges to provide a roadmap for reducing suicide by 20 percent in 5 years, 40 percent or more in 10 years.

But make no mistake – this is a tough scientific problem. Research has demonstrated that the factors that contribute to suicide are multiple and complex. No single approach will suffice and there are no simple answers to why any one individual takes his or her own life. As we go forward, research will have to help us move from risk groups to individual risk. By understanding risk, we can develop ways to achieve the most important goal, prevention. The spectacular recent success in AIDS research has taught us that treatment is the best prevention. If we can identify who is at highest risk and intervene aggressively for those individuals, we can save lives.

The challenge is especially urgent in the military where suicide rates have doubled. In the army, suicide deaths have outnumbered combat deaths for the past 3 years. The issue has also been recently prioritized by President Obama, who signed an executive order on August 31, "Improving Access to Mental Health Services for Veterans, Service Members, and Military Families." The executive order broadly targets mental health care, with some directives aimed expressly at suicide prevention, including increasing the U.S. Department of Veterans Affairs (VA) veteran crisis line capacity by 50 percent by the end of 2012; ensuring that any veteran identifying him or herself as being in crisis is connected with a trained mental health provider within 24 hours; and directing the VA to work with the Department of Defense to implement a national 12-month suicide prevention campaign focused on connecting veterans to mental health services. The executive order calls for a longitudinal study of risk and resilience in 100,000 soldiers by the end of this calendar year. Working with the Army STARRS study, we are determined to make that goal, providing a Framingham-like study for military mental health.

The National Strategy is a blueprint for diverse agencies, organizations, and communities to work together in a coordinated, focused way. The 13 goals and 60 objectives included in the National Strategy are aimed at saving lives. Who would not be inspired by the vision of a nation free from the tragic experience of suicide? To begin to realize this vision, we have a lot of work to do.

You can hear more about the new strategy in this new video featuring NIMH's suicide prevention research expert, Jane Pearson, PhD.