International Perspectives on Suicide Prevention and Postvention

City Hotel – Londonderry Tuesday, 4 September 2012

Jerry Reed, Ph.D., MSW

Suicide Prevention Resource Center Promoting a public health approach to suicide prevention

“Nothing great has been and nothing great can be accomplished without passion.” G.W.F. Hegel

Agenda

• Introduction

• Model for Action

• International Perspective

• US Perspective

• Selected Accomplishments

• Sector Engagement

• The Future

• Conclusion

The Model for Action

Prevention Priorities

Social Strategy

Knowledge Base

Political Will

Richmond and Kotelchuck’s Health Policy Model Found in: Atwood, K, Colditz, G. A., Kawachi, I. (1997). From public health science to prevention

policy: Placing science in its social and political context. American Journal of Public Health, 87(10).

"Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope"

Suicide in the World • 1 million suicide deaths

annually worldwide

• Suicide is a largely preventable form of death

• Many nations have or are developing a National Strategy for Suicide Prevention

• Low and middle income countries bear the highest burden. Culture matters

• Strategies should include thoughts to plans to attempts to completions

• Number of attempts could be 20 times higher than deaths

• A leading cause of death worldwide

• 1.6 male suicides on average for every female death

• Attempt rate 2-3 times higher among women

• More deaths to suicide worldwide than homicide and wars combined

• Suicide is complex interacting with biological, social, psychological and environmental risk and protective factors

Global Priorities for Suicide Prevention • Continue to research suicide and non-fatal

suicidal behavior, addressing both risk and protective factors.

• Develop and implement awareness campaigns, with the aim of increasing awareness of suicidal behaviors in the community, incorporating evidence on both risk and protective factors.

• Target our efforts not only to reduce risk factors but also to strengthen protective factors, especially in childhood and adolescence.

• Train health care professionals to better understand evidence-based risk and protective factors associated with suicidal behavior.

• Reach people who don’t seek help, and hence don’t receive treatment when they are in need of it.

• Ensure sustained funding for suicide research and prevention.

• Combine primary, secondary and tertiary prevention.

• Increase use of and adherence to treatments shown to be effective in treating diverse conditions; and to prioritize research into effectiveness of treatments aimed at reducing self-harm and suicide risk.

• Increase the availability of mental health resources and to reduce barriers to accessing care.

• Disseminate research evidence about suicide prevention to policy makers at international, national, and local levels.

• Reduce stigma and promote mental health literacy among the general population and health care professionals.

• Influence governments to develop suicide prevention strategies for all countries and to support the implementation of those strategies that have been demonstrated to save lives.

“A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history.” Mahatma Ghandi

Key Milestones

US Selected Accomplishments Legislation

Senate Resolution 84 & House Resolution 212

Joshua Omvig Veterans Support Act

Garrett Lee Smith Memorial Act

Jason Flatt Act

Matt Adler Suicide Assessment, Treatment and Management Act

Other legislation to advance local and state efforts

Programs/Events

National Suicide Prevention Resource Center

Reno Conference

National Strategy for Suicide Prevention

National Suicide Prevention Lifeline

National Survivors Day

National Action Alliance for Suicide Prevention

Prevention of Suicide: Guidelines for the formulation and implementation of national strategies (United Nations, 1996)

• “National Governments should establish or designate a governmental or non-governmental coordinating body to be responsible for the prevention of suicidal behavior”

• Employ the public health approach

Key elements

• Support from government policy

• Follow a conceptual framework

• Well-defined aims and goals

• Measurable objectives

• Identification of agencies and organizations capable of implementing objectives

• Ongoing monitoring and evaluation

Activities and Approaches

• Promote early identification, assessment, treatment and referral of persons at risk

• Increase public and professional awareness and access to information

• Integrated data collection system

• Comprehensive training and service programs

• Supportive and rehabilitative services

• Reduce availability of means

Prevention of Suicide: Guidelines for the formulation and implementation of national strategies (United Nations, 1996)

The Action Alliance for Suicide Prevention

Suicide prevention is everyone’s business…

We all have a role to play.

Sectors That Have a Role • Public health sector

• Mental health services

• Education sector

• Legal authorities

• First responders

• Parliamentarians, policy makers, and politicians

• Stakeholders representing vulnerable groups

• Survivors and families

• Community leaders

• Spiritual leaders

• Religious leaders

• Media

• Researchers

• Epidemiologists and national statisticians

• Professional Associations

• Private sector

• Business sector

• Foundations

• Suicide prevention NGOs

“A small group of thoughtful people could change the world. Indeed, it’s the only thing that ever has.” Margaret Mead

Some of What I See in the Future • Greater emphasis on continuum

from promotion to prevention to intervention to postvention

• Better integration and use of data

• Emphasis on training both community gatekeepers and professionals

• Stronger emphasis on continuity of care and integration of existing resources

• Continued engagement of media on responsible reporting

• Engagement of new sectors who have a role to play

• Focus on populations at risk

• Engagement of health systems

• Integration of public health and mental health

• Better exploration of upstream suicide prevention efforts

• Changing the conversation to what we can do versus what the problem is

• Efforts to reduce prejudice and discrimination

• Greater research and evaluation

• Greater emphasis on hope, help, resilience, wellness and recovery

“You must be the change you want to see in the world.” Mahatma Ghandi

Follow the Yellow Brick Road!

Contact

Jerry Reed, Ph.D., MSW Director, Suicide Prevention

Resource Center jreed@edc.org (202) 572-3771