Suicide Prevention: A National Priority

At age 16, Jordan Burnham was a popular high school student, always smiling and laughing. Being diagnosed with depression came as a surprise, as he had become an expert in hiding his feelings.

“It seemed as though I had everything that I wanted—a girlfriend, playing sports, popular. But still, it felt like there was a hole inside of me, and I couldn’t figure out why I had a lack of motivation to get out of bed, why I was randomly crying,” Jordan says.

The pressure to do well in school, fit in, and make his parents proud led to drinking and suicidal thoughts. In 11^th grade, Jordan was hospitalized. But despite medication and twice-weekly sessions with a counselor, Jordan didn’t immediately take his depression seriously. In therapy, he says, “I was probably 80 percent honest,” and he didn’t admit that he had stopped taking his medication.

It took a suicide attempt at age 18 to shock Jordan into making a commitment to get healthy. That meant taking his medication regularly, being completely honest with his therapist, stopping his drinking, and tapping into a strong support system, including his parents. Knowing it was a miracle to be alive after his suicide attempt, Jordan became determined to make his second chance a positive one.

“I knew that I could cope with depression in a better way,” he realized. “I just wanted to be content with how my life was and try to help other people so that it didn’t get to that point for someone else. The main message is that you’re not the only one going through these problems, but you can verbalize them, and you can cope with them in a healthy way.”

Jordan is sharing his message through media appearances and a video for suicide attempt survivors, Stories of Hope and Recovery, released by SAMHSA this fall. Jordan is not alone; SAMHSA’s 2010 National Survey on Drug Use and Health (NSDUH) shows that 3.8 percent of adults age 18 and older in the United States, or an estimated 8.7 million people, had serious thoughts of suicide within the past year. Approximately 2.5 million adults made suicide plans in the past year, and 1.1 million adults attempted suicide in the past year. Like Jordan, many people who struggle with suicidal thoughts also have problems with substance use; the 2010 NSDUH also indicates that adults who have substance dependence or misuse are more than four times more likely to report serious thoughts of suicide than those who do not.

Suicide Prevention Strategy

To reduce the number of people like Jordan who suffer needlessly from suicidal thoughts, SAMHSA and the U.S. Department of Health and Human Services (HHS) have made suicide prevention a national priority. This fall, U.S. Surgeon General Regina Benjamin, M.D., M.B.A.—along with the National Action Alliance for Suicide Prevention, a national public-private collaboration that includes SAMHSA—issued the 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action.

For the past 10 years, the nation has been guided by a 2001 strategy that was released by then-Surgeon General David Satcher, which laid the groundwork by organizing a strategic approach to suicide prevention. One of the major milestones from the first National Strategy was the formation of the National Action Alliance, which advances suicide prevention efforts nationwide and was tasked with updating the National Strategy over time.

The newest National Strategy identifies ways to reduce the incidence of suicide across the nation and within high-risk populations, such as older men, individuals bereaved by the suicide of someone close to them, and those with a mental or substance use disorder. It reflects advances in understanding effective suicide prevention approaches, such as talk therapy, crisis lines, use of technology, and close coordination of care among health care professionals.

For example, a 2012 U.K. study cited in the National Strategy shows that suicide rates can be significantly reduced through applying a comprehensive set of suicide prevention recommendations, including providing 24-hour crisis teams and conducting community outreach. Other helpful measures include:

• Removing access to materials that could be used for suicide
• Training frontline staff within mental health systems to better manage suicide risk
• Contacting people within 7 days of their discharge from a mental health program
• Developing written policies for sharing information about suicide risk with criminal justice agencies
• Following up with patients who are not adhering to treatment
• Addressing co-occurring disorders (a combination of a mental and a substance use disorder)
• Reviewing and sharing information with families after a suicide.

Among these recommendations, providing 24-hour crisis care was linked to the largest decrease in suicide rates. The SAMHSA-funded National Suicide Prevention Lifeline , 1–800–273–TALK (8255), provides more than 800,000 callers a year with confidential, 24/7 crisis counseling and mental health referrals through a national network of more than 155 local crisis call centers.

Comprehensive Solutions Needed

Historically, as the National Strategy outlines, suicide prevention was viewed as the primary territory of mental health agencies because of its close link to mental illness. However, most people who have a mental disorder do not engage in suicidal behaviors, according to an Institute of Medicine study cited in the National Strategy. Moreover, mental health is only one of many factors that can influence suicide risk; life experiences such as trauma or having chronic physical pain also can affect suicide risk.

The new National Strategy recognizes that it will require comprehensive solutions to address the complicated problem of suicide, with multiple approaches implemented at multiple levels. For example, enhancing people’s connections to others—something anyone can do, regardless of background or profession—can help reduce feelings of depression and isolation, which contribute to suicide risk, according to the Suicide Prevention Resource Center (SPRC) .

The National Strategy notes that with the advent of new technologies, it is becoming even easier to help people in crisis. These include mobile apps that enable people to chart moods and access crisis lines and a new Facebook feature that enables the reporting of suicidal content. Working together to change the conversation and remove barriers to life-saving help can be extremely rewarding, as Jordan Burnham attests: “It’s very therapeutic to be able to tell my story, knowing that it’s helping someone else and knowing that I’m making a difference in adding a positive light to society.”