NATIONAL STRATEGY FOR SUICIDE PREVENTION

At a Glance - Suicide Prevention Initiatives within the Department of Health and Human Services

Centers for Disease Control (CDC)

• Public health initiatives: CDC has been a pioneer in raising the awareness of suicide as a critical health issue in which public health can play a role. CDC conducts and supports surveillance, prevention?oriented research, and studies of effectiveness of specific interventions in preventing suicide. CDC has developed documents to assist communities in identifying and implementing the best available youth suicide prevention programs and assisted states in developing statewide suicide prevention plans.
  
  
• Community-based interventions among Native Americans: CDC supports the testing and evaluation of suicide prevention and community assistance including a project targeting Native American groups. CDC's focus has been on community-based prevention strategies.
  
  
• Youth Violence Prevention: CDC is establishing a Congressionally mandated National Resource Center on Youth Violence Prevention. The purpose of the Resource Center is to provide youth violence and suicide intervention information to various constituents. The Center consists of four components, a toll-free information and referral service, an Internet Web site, a communication plan for informing various audiences about the Center, and technical assistance.
  
  
• Surveys: CDC conducts a nationally representative survey to examine health risk behaviors among high school students, another survey on risk and protective factors among adults, and a national sample examining injuries seen in emergency departments.
  
  
• Research center: CDC supports the Suicide Prevention Research Center at the Trauma Institute, University of Nevada School of Medicine and other extramural research that examines protective factors and non-mental illness-related risk factors for suicide in the general population.
  
  
• Institute of Medicine study: CDC is supporting an Institute of Medicine report that will be a comprehensive examination of the field of suicidal behavior.
  
  
• Conference: CDC is funding a conference in collaboration with the Suicide Prevention Advocacy Network to develop evaluation tools for suicide prevention programs.
  
  
• Violent death reporting system: CDC recently submitted through the the President's budget a request for $20M to implement a nationwide violent death reporting system. A system of this nature would significantly improve understanding of events and circumstances surrounding deaths due to suicide.

Health Resources and Services Administration (HRSA)

• Integration of primary care and mental health services: HRSA works to improve the Nation's health by assuring equitable access to comprehensive quality health care. Suicide prevention activities of HRSA include programs and activities in the Bureau of Primary Health Care, and Maternal and Child Health Bureau. These programs promote integration of primary care and mental health services, develop and implement State Suicide prevention plans and programs, and ensure access to appropriate screening and services for depression through grants, contracts, technical assistance, and conference sponsorship.
  
  
• Technical assistance: Through ten HRSA Field Offices, technical assistance is provided to States and HRSA grantees in building capacity in suicide prevention.
  
  

• Block grants: The Maternal and Child Health State Block Grant Program has made reduction in the rate of youth suicide a priority for state Maternal and Child Health agencies. All states annually are required to report on their progress toward achieving targets set for rates of suicide deaths among youths aged 15-19 as one of its 18 National Performance Measures. State data and activities for multiple years related to youth suicide are posted on the Title V Information System (http://mchb.hrsa.gov) The Maternal and Child Health Bureau funds the Children's Safety Network to assist state Maternal and Child Health Programs in the development of suicide prevention efforts. The Children's Safety Network has published a Youth Suicide Prevention Fact Sheet Packet. (http://www.edc.org/HHD/csn/Publications/violprev.htm)

  HRSA grants and contracts contributing to suicide prevention include:

  Bureau of Primary Health Care: Inclusion of mental health services in community health centers, recruitment and placement of mental health providers in designated mental health shortage areas.

  Maternal and Child Health Bureau: Integrated health and behavioral health care for children and adolescents and their families and improving women's health through screening and intervention for depression during or around time of pregnancy.

Indian Health Service (IHS)

• IHS Behavioral Health Program has, as a performance indicator, the collection of data regarding suicidal behavior (completions and attempts). All participants in our 11 Youth Regional Treatment Centers are closely screened for suicide risk and appropriate referrals made. IHS works closely with the Bureau of Indian Affairs (BIA) Boarding Schools to address the issue of suicide risk of students and IHS mental health professionals work with the BIA school staff. Cross training of alcoholism counselors and mental health staff is provided. The National Suicide Center located on the Jicarilla Apache Indian reservation in New Mexico provides training upon request for AI/AN communities. The Center also has staff to provide treatment on an outpatient basis.

National Institutes of Health, National Institute of Mental Health

• Research studies: NIMH is now funding 7 studies focused specifically on reducing suicidal behavior; 3 of these are the PROSPECT study (detecting and treating geriatric depression in primary care). NIMH has developed documents to help researchers identify and use sound measures of suicidality, and safe approaches to developing treatment studies, to facilitate this research. A workshop on the ethics of conducting clinical trials with suicidal individuals takes place this summer. NIMH will fund a small business contract to support a website for information on suicide risk factors and prevention approaches. NIDA currently funds 3 grants that focus on suicidal behavior. The first is a longitudinal study of risk and protective factors for drug abuse and adverse outcomes including psychiatric co-morbidity, including depression, self-harm, and co-morbidity. The second study uses New York City medical examiner data to track fatal injuries, homicide, and suicide associated with drug abuse. The third is a patient-oriented career development award that studies drug-related harm, specifically drug-related suicidal or homicidal behavior. NIAAA supports research directed at elucidating the causal role of alcohol in suicide and identifying risk factors for suicide among alcoholics. NIDA and NIAAA are co-funding a study that examines suicide as an outcome of the effects of supervisory and emotional neglect on adolescents and young adults. NIDA and NIMH are cofunding a study that examines the efficacy and effectiveness of short-term cognitive therapy on survivors of suicide attempts.
  
  
• Conferences: NIMH is funding a 5-year conference grant that is assessing the state of the science in suicide prevention across age, gender and ethic groups. Co-funding for this conference includes National Institute on Drug Abuse (NIDA), National Institute of Alcohol Abuse and Alcoholism (NIAAA), National Institute of Child Health and Human Development, National Institute on Aging, National Institute of Nursing Research. First annual conference, focused on youth suicide, will be June 13,14, 2001.
  
  
• Institute of Medicine Study: NIMH, NIDA, and NIAAA are primary sponsors of an Institute of Medicine study of suicide prevention (with Substance Abuse and Mental Health Services Administration (SAMHSA) and Centers for Disease Control (CDC).
  
  
• Program announcement: NIDA cosponsored a program announcement with NIMH to focus on youth suicide prevention.

Substance Abuse and Mental Health Services Administration (SAMHSA)/Center for Mental Health Services

• National suicide prevention website: A comprehesive Web site resource is being launched on May2 in collaboration with NIMH, CDC and OSG which will serve to provide a wide array of suicide prevention related information and resources for mental health professionals, health care providers, community coalitions, policymakers, survivors, and advocates.
  
  
• Youth suicide prevention cooperative agreements: Four cooperative agreements were awarded to community-based organizations to promote prevention of youth suicide--to build community-wide understanding of youth suicide; to build real and sustainable community-wide collaborations; and to implement and sustain evidence-based youth and family service programs.
  
  
• School guidelines: Work is underway to develop guidelines for suicide prevention in schools, in collaboration with the NIH and the Department of Education, based on the New Zealand model.
  
  
• School depression screening: CMHS supports the National Depression Screening Day High School Outreach Program, a school-based screening model developed by Screening for Mental Health, Inc., and is guiding efforts to expand the activities of this depression screening to include alcohol and more specific suicide risk.
  
  
• Anti-stigma: CMHS has commissioned a review of the role of mental health anti-stigma campaigns in suicide prevention.
  
  
• Institute of Medicine study: SAMMHSA is supporting a study by the Institute of Medicine, National Academy of Sciences, which will assess the science base of the root causes of suicide an examine the vulnerability of specific populations.
  
  
• Conference: SAMHSA is supporting a 5-year series of annual conferences (see above) organized by the University of Rochester School of Medicine's Center for the Study and Prevention of Suicide to advance the science of suicide prevention.
  
  
• Cooperative Agreements to Certify, Network and Evaluate Crisis Programs that Offer Hotline Services: This funding announcement solicits applications for two cooperative agreement awards. Approximately $2.55 million per year for three years is available for a Certification and Networking grant to increase the number of crisis programs offering hotline services that are certified in suicide prevention, increase the number of certified crisis centers/hotlines that are networked through a single, nationwide toll?free number, and evaluate the adherence to certification standards over time, as well as, the characteristics and quality of telephone interventions with suicidal callers. Approximately $450,000 per year for three years is available for Client and Community Centered Outcomes evaluation, the purpose of which is to explore, identify and define client and community?centered outcomes in relation to crisis programs that operate suicide prevention hotline services and evaluate the effectiveness of crisis programs in reducing the overall suicide rate in the communities they serve.