National Strategy for Suicide Prevention:
Goals and Objectives for Action

GOAL 10:
Promote and Support Research on
Suicide and Suicide Prevention

Much is known about the risk factors associated with suicide, but less about how to modify certain risk factors effectively to reduce the likelihood of suicidal behaviors occurring. Protective factors have been shown to reduce risk for suicide, but little is known about how to enhance these protective factors with individuals already at risk (Felner, Felner, & Silverman 2000). Some good hints are available about what interventions may be effective, but little information about the long term effects of these interventions and about the variables that may influence their effectiveness (Silverman & Felner, 1995). For instance, variables regarding the intervention itself (for whom and for how long, how often, how intensively, and under what circumstances) must be studied to determine which are critical in ensuring that the intervention works.

A great deal about the media and its effect on individuals is known, but little about culturally appropriate messages and how to deliver them to targeted populations to reduce suicide (see Objective 9.1). By advancing a comprehensive research agenda, industry and government, working together, can contribute significantly to the development of a knowledge-base on the causes of suicide and the development of interventions aimed at prevention.

A good deal of information about individuals at risk for suicide has emerged from epidemiological surveillance studies. Biological and genetic research has begun to identify markers for increased risk for suicide. For example, studies showing decreased 5-hydroxy indoleacetic acid in cerebrospinal fluid along with genetic linkage studies, suggest that certain individuals may be at increased risk for the expression of suicidal behaviors.

All suicides are highly complex. The volume of research on suicide and suicide prevention has increased considerably in the past decade and has generated new questions about why individuals become suicidal or remain suicidal. The important contributions of underlying mental illness, substance abuse, and biological factors, as well as potential risk that comes from certain environmental influences are becoming clearer. Increasing the understanding of how individual and environmental risk and protective factors interact with each other to affect an individual's risk for suicidal behavior is the next challenge.

Like the U.S., other nations are working to build national suicide prevention plans on solid scientific evidence (see Introduction). Evaluation of their efforts are underway and offer the opportunity to learn important lessons from their experiences.

The field of suicidology has significantly advanced as a result of research findings from many related fields including sociology, psychology, psychiatry, biochemistry, neuropharmacology, and epidemiology. These findings have been translated into screening and assessment tools, treatment and resiliency-building interventions, and treatment and symptom monitoring techniques. Continued advancements in the prevention of suicidal behaviors can only come with solid support of a wide range of basic, clinical, and applied research endeavors designed to enhance understanding of the etiology, development, and expression of suicidal behaviors across the life span as well as those factors which enhance resiliency. Such enhanced understanding will lead to better assessment tools, treatments, and preventive interventions. It will also lead to more effective and efficient therapeutic interventions for survivors of suicide attempts.

Everyone has a stake in the development and implementation of a national suicide research agenda. Everyone who is touched by suicide has a contribution to make to better understand the individual who has committed suicide and the suicidal process. A coordinated research agenda will benefit everyone affected by suicide and other life-threatening behaviors.

An agenda might address the who, what, when, where, why, how, and how much questions of suicide. The targets for such an agenda might include increased attention to high risk groups, gender and ethnic differences, geographical distribution, means restriction, economic changes, surveillance, genetic contributions, protective factors, and psychotherapy and psychopharmacology as potential treatment and preventive interventions.

Such an agenda might include research on specific aspects of prevention, intervention, or postvention, including basic, applied, clinical, evaluation, community-based intervention, and media-based research.

Scientific knowledge must be translated into practice and general applications, including educational settings, justice, occupational, and elderly programs. Learning more about how to transfer such knowledge effectively will benefit all concerned. Important findings and ideas for implementation must not be overlooked or lost because their potential for rapid application are not immediately appreciated. A real need exists to improve the translation of basic scientific research findings into recommendations and suggestions for practical application.

Despite the increase in interest in suicide and suicide prevention research, there remains a shortage of researchers trained in the field of suicidology and trained in research methods most applicable to suicide and suicide prevention.

Basic, applied, clinical, and preventive intervention research must focus more on suicide and life-threatening behaviors. Not only is it important to support research in these areas, but also to review existing research to gather those findings that have the most potential for application in community and clinical settings. By comparing and contrasting outcomes and findings, appropriate decisions can be made about which directions to pursue and which approaches are no longer fruitful. Having access to such a registry that identifies evidence-based models or best practices allows individuals or communities to apply them or build upon them in developing local initiatives.

In promoting better research on suicide and suicide prevention, it is important to develop better evaluation research tools, techniques, and approaches to determine whether interventions do, in fact, work and how effectively and efficiently they achieve the goals stated. Evaluation studies may include measurements of cost-effectiveness, cost-offset, and cost-benefit. It is only through carefully designed, implemented, and evaluated intervention studies that better preventive interventions can be provided to achieve the goal of reducing suicide rates in the nation. (See Objective 4.8).

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