Suicide Prevention: General Public and the Community-At-Large

 

Introduction

With the rising rates of suicide in the U.S., the demand for a proactive and coordinated response from both the public sector and local communities is growing. Everyone has a role to play in the fight against suicide, and research has shown that personal and community connectedness can make a significant difference in the lives of those at risk for suicide. According to the Suicide Prevention Resource Center, increasing the connections among individuals, family, community, and social institutions can be a protective factor for preventing suicide.1 Research also shows that individuals who are having thoughts of suicide feel relief when someone asks about them in a caring way.2 Helping to connect a person at risk to a support system, including providing resources to reach out to (friends, family, clergy, therapist, support groups, hotlines, etc.), is a step that anyone in the community can make. In addition to providing social support to vulnerable individuals, communities and community members can engage in follow up care, fight stigma, and support those bereaved by suicide.3

Suicide is often surrounded in stigma, shame, and misunderstanding, causing many individuals to not seek the help they need. Being a caring member of the community can go a long way in preventing suicide and suicidal thoughts and behaviors.

 

Suicide Prevention and Crisis Intervention Pathways for Communities

For communities to be successful in addressing suicide, they need a comprehensive approach to suicide prevention and crisis intervention.  As communities build out robust prevention programs, they also need to be working on developing plans around crisis intervention. 

The process of building community suicide prevention efforts begins by initiating conversation and creating a team of individuals who will maintain the role of facilitating suicide prevention efforts. Involving the community by engaging stakeholders (i.e. employers, local organizations, government officials, mental health groups), hosting community meetings, formulating community goals, and working with the media can all benefit community level suicide prevention efforts. Suicide prevention efforts should be informed by the key issues faced within communities (i.e. stigma, social stressors, lack of trained mental health workers, access to mental health care), the resources already available (counseling, primary care, sports clubs, events), and the skills and strengths of individuals and organizations in the community. The World Health Organization created a Guide to Community Engagement in Suicide Prevention with comprehensive details and case examples for each step of the pathway below.

 

Community Pathway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Issues that a community may wish to address in its action plan could include (Allen et al., 2014):4

  • stigma around suicide due to religious or cultural beliefs within the community;
  • lack of understanding of suicide within the community;
  • access to easily available and ready means of suicide (e.g. pesticides, firearms);
  • easy availability of alcohol due to unrestricted sale and production;
  • social stressors (e.g. stress among school or university students during examinations);
  • local media outlets that sensationalize suicide through inappropriate reporting;
  • lack of support and services available for those who are vulnerable to or bereaved by suicide;
  • lack of trained health workers in the community or district health facilities;
  • lack of psychosocial counseling (e.g. in the community, at schools, at social centers).

 

Persons in need of support and services may include those who:

  • have lost a loved one to suicide;
  • have made previous suicide attempts;
  • have mental health problems and challenges;
  • have experienced harmful use of alcohol or other substances;
  • have suffered financial loss;
  • have experienced chronic pain or illness;
  • have a family history of suicide;
  • have suffered abuse or violence.

 

For Employers

One important aspect of the community is the workplace. People often spend a large portion of their day at work, putting employers and colleagues in an important position to notice any behaviors that could suggest risk for suicide or other mental health issues. Because of this, having suicide prevention activities in the workplace is very important. Employees are often hesitant to share whether they are experiencing difficulties for fear of jeopardizing their employment or career advancement.4 While suicide among employees is often a result of the complex interactions among individual vulnerabilities, stressful work conditions, and living conditions, workplaces and employers play in important role in fulfilling a supportive or gatekeeper function for suicide prevention.5 Additionally, good mental and physical health can enhance workplace productivity. Communities can collaborate with workplaces, employers, and employees to facilitate training in suicide prevention. Below is a comprehensive blueprint for workplace suicide prevention by the National Action Alliance for Suicide Prevention.6

 

Comprehensive Blueprint for Workplace Suicide Prevention

Comprehensive Blue Print

Screening: Businesses can provide employees and staff with tools that help them self-assess for levels of anxiety, depression, substance abuse, etc. Gauging one’s mental health can serve as a starting point for further services. See Screening Section for screening tools that can be self-administered.

Mental Health Services and Resources: Employers can provide resources to employees who may be struggling with a mental health condition or suicidal ideation. These resources can include local agencies, treatment locations, online resources, support groups, or educational materials. See resources section for mental health resources.

Suicide Prevention Training: Businesses should provide training to staff and employees on how to recognize the warning signs of suicide and how to link employees, coworkers, or other staff to care. Typically, a suicide prevention gatekeeper training is offered to managers, supervisors, and human resources staff, but can also be applied to all employees of the business. See Training section for more information.

Life Skills and Social Network Promotion: Businesses should provide wellness programs that promote conflict resolution, stress management, and other life skills. These types of programs can foster protective factors that can decrease suicide risk.

Crisis Management, Policy, and Means Restriction: Crisis management focuses both on prevention and postvention through approaches designed to assist those affected by a suicide or suicide attempt by decreasing negative responses and increasing the ability to cope. Lethal means counseling can be provided to families or friends of loved ones who are at risk for suicide or exhibiting suicidal behavior.

Education and Advocacy: Providing employees and staff with educational resources on common mental health conditions and suicide can reduce some of the social barriers to seeking help.

  • American Association of Suicidology: Promotes research, public awareness, programs, public education, and training for professionals and volunteers, and serves as a national clearinghouse for information on suicide.  Provides PDF of information sheets and research.
  • American Foundation for Suicide Prevention: Supports research, provides information and education about depression and suicide; sponsors National Suicide Survivor Day (November), and provides videos, facilitator guides, and website printouts.
  • Center for Workplace Mental Health: Provides tools to help employers make the business case with employer case examples.  
  • Families for Depression Awareness: Provides educational workshops to employers on mental health topics and helps families recognize and cope with depressive disorders to get people well and prevent suicides through webinars, publications, website, speakers, etc.
  • Mental Health America: Supports National Mental Health Awareness Month (May), provides mental health information (including workplace mental health), hosts national conference, and has online educational printouts and an affiliate search database on website.
  • Partners in Recovery: Supports “Loving a Suicidal Person” and provides training, home-based services, and recovery services.
  • Screening for Mental Health: Online and in-person mental health education and screening programs, including National Depression Screening Day kits, online screening, and in-person screening kits.
  • Suicide Prevention Lifeline: Program of SAMHSA and the Mental Health Association of NYC. Hotline/Crisis Center 1-800-273-8225.
  • Suicide Prevention Resource Center: Funded through a grant under SAMHSA, SPRC provides trainings and webinars on suicide prevention, publications, toolkits, guides, research summaries, webinar, online courses, and information sheets on a variety of suicide prevention topics.
  • Working Minds: Provides educational workshops and keynote addresses for workplace conferences; has a website with a workplace-screening tool, train-the-trainer workshop and training toolkit, fact sheets and blueprint for change, and employer testimonial videos.

Social Marketing: Businesses can help change the conversation and employee’s behavior by positioning the work of suicide prevention as part of the company’s value for health and safety. By using social marketing and social media tools, messaging to the workplace community can let employees know that those who struggle are not alone and that the leaders of the workplace make their health and safety a priority.

Leadership: When there is genuine top-down support from leadership for mental health promotion and suicide prevention, the community is more likely to change.

 

Training

There are a wide variety of trainings available for all members of the community. Training in suicide prevention is important at all levels of the community, including lay people, business owners, government officials, educators and teachers, sports coaches, parents, faith organizations, etc.

QPR Institute
QPR Institute provides a number of trainings for professionals and lay people in recognizing and responding effectively to someone showing suicide warning signs and behaviors. An initial Gatekeeper training is available online and the QPR intervention has been used successfully on a variety of age groups and populations. In addition to the general gatekeeper training, there several other trainings available on the QPR Institute website.

ALGEE: The Action Plan Assess, Listen, Give, Encourage and Encourage

Mental Health First Aid (MHFA) and MHFA at Work
In a partnership with the National Council for Behavioral Health, the American Foundation for Suicide Prevention hosts MHFA trainings across the country. MHFA is an eight-hour training that teaches participants a five-step action plan to help someone who is suffering from a mental health crisis through identification, understanding, and responding to signs of mental illness. This training is available virtually and is meant for anyone within the community, including parents, teachers, neighbors, veterans, first responders, etc.

Applied Suicide Intervention Skills Training (ASIST)
ASIST is an interactive, practice-oriented workshop that teaches first aid to caregivers with a focus on encouraging help- seeking in at-risk individuals. This training is designed for any caregivers of older adults, including paraprofessionals, professionals, and lay people. Those trained learn how to prevent suicide by recognizing warning signs, providing intervention, and developing a safety plan.

safeTALK
safeTALK is a training that prepares anyone over the age of 15 to identify persons with thoughts of suicide and connect them to suicide first aid resources, while also teaching trainees how to prevent suicide by recognizing signs, engaging someone, and connecting them to an intervention resource for further support. safeTALK also has a train-the-trainer program, which could be useful for employers and other organizations within communities.

Working Minds
Working Minds is an evidence-based program that is designed to promote mental health and reduce stigma around mental illness in the workplace. The website contains a workplace-screening tool, train-the-trainer workshop, and training toolkit. The train-the-trainer workshop is 3 ½ hours and is designed to build capacity within a workplace so that staff internal to the organization can deliver this training with cultural relevance.

 

Additional Resources

 

References

  1. https://sprc.org/risk-and-protective-factors/
  2. https://suicidepreventionlifeline.org/promote-national-suicide-prevention-month/
  3. Preventing suicide: a community engagement toolkit. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
  4. Allen J, Mohatt GV, Beehler S, Rowe HL. People awakening: collaborative research to develop cultural strategies for prevention in community intervention. Am J Community Psychol. 2014 Sep;54(1-2):100-11. doi: 10.1007/s10464-014-9647-1. PMID: 24903819; PMCID: PMC4119558.
  5. https://apps.who.int/iris/bitstream/handle/10665/272860/9789241513791-eng.pdf?ua=1
  6. https://theactionalliance.org/resource/comprehensive-blueprint-workplace-suicide-prevention
  7. Scope of the Problem – Suicide Prevention Resource Center (sprc.org)
  8. sprc.org/wp-content/uploads/2022/12/2016-Montana-Suicide-Mortality-Review-Report.pdf
  9. http://www.sprc.org/resources-programs/calm-counseling-access-lethal-means