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The Nation Focuses on Suicide Prevention with Unique Interventions


Suicide is a growing concern, taking the lives of twice as many people on average as homicide, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). About 100 Americans take their own lives each day and more than 8 million U.S. adults seriously consider it each year. US Surgeon General Dr. Regina Benjamin, US Health and Human Services Secretary Kathleen Sebelius, and Army Secretary John McHugh have announced a plan to help reduce these devastating statistics.

"It takes the entire community to prevent suicides. It's not just one individual," says Dr. Benjamin. "We call can play a role."

One area of major concern is the number of military personnel who have committed suicide over the past year. So far in 2012, there has been a 22% increase in the number of self-inflicted deaths among our active-duty soldiers over last year. The Army announced last month that 116 took their lives during the first seven months of this year. The Department of Veteran Affairs reports that there were 17,754 suicide attempts among veterans, up from 10,888 in 2009.

General Ray Odierno, Army chief of staff, has said that suicides are now the most common form of death in the Army, claiming more lives than combat or motor vehicle accidents. The Marine Corps and Coast Guard also report increases in suicide rates. Nearly 20% (one in five) returning war veterans suffer symptoms of PTSD (post traumatic stress disorder).

"There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, a researcher at RAND, a nonprofit research organization. "Unless they receive appropriate and effective care for (their) mental health conditions, there will be long-term consequences for them and for the nation,” adds Gen. Odierno.

Dr. Timothy Lineberry MD, a Mayo Clinic psychiatrist and suicide expert for the Army said. "Despite the anticipated end of large-scale military operations in Afghanistan and Iraq, the effect on the mental health of active-duty service members, reservists, and veterans is only just beginning to be felt."

Thus, the need for a greater emphasis on suicide prevention.

The Action-Alliance, a public-private partnership advancing the National Strategy for Suicide Prevention has announced its most recent efforts intended to save 20,000 lives over the next five years. Following is a list of its first four priorities:

1) Integrate suicide prevention into health care reform and encourage the adoption of similar measures in the private sector. The Action Alliance will work in partnership with the Centers for Medicare and Medicaid Services (CMS).

2) Transform health care systems to significantly reduce suicide. The Action Alliance will promote the adoption of “zero suicides” as an organizing goal for clinical systems by providing support for efforts to transform care through leadership, policies, practices, and outcome measurement.

3) Change the public conversation around suicide and suicide prevention. The Action Alliance will leverage the media and national leaders to change the national narratives around suicide and suicide prevention to ones that promote hope, connectedness, social support, resilience, treatment and recovery. This initiative will fundamentally transform attitudes and behaviors relating to suicide and suicide prevention.

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4) Increase the quality, timeliness, and usefulness of surveillance data regarding suicidal behaviors. The Action Alliance will work with the Centers for Disease Control and Prevention and other public and private partners to improve suicide data and expand existing data systems.

One major effort announced today is the use of Facebook so that those who are concerned about family and friends can report suicidal comments that potential victims may post. The service will then send an email urging those who are considering taking their own lives to call the national hotline - 1-800-273-TALK (8255) - and offer an opportunity to chat online, confidentially, with a counselor.

"All too often, people in crisis do not know how - or who - to ask for help," Facebook Global Vice President for Public Policy Marne Levine said in a statement. "We have a unique opportunity to provide the right resources to our users in distress, when and where they need them most."

Dr. Lineberry has published an article in the September edition of Mayo Clinic Proceedings in which he outlines steps to assess and address military suicide. These are:

• Reduce access to guns and other means of suicide. Nearly 70 percent of veterans who commit suicide use a gun to do it. Veterans are more likely to own firearms. All veterans with psychiatric illness should be asked about their access to firearms and encouraged to lock up guns, giving someone else the key, or remove them from the home altogether. Just slowing down gun access by a few minutes may be enough to stop the impulse.

• Watch for sleep disturbances. Complaints of insomnia or other sleep disturbances in otherwise healthy soldiers, reservists, or veterans may signal the need for taking a careful history and screening for depression, substance misuse and post-traumatic stress disorder. Sleep disturbances have been previously identified as a risk factor for suicide. These complaints may also serve as opportunities for referring those potentially needing more intensive treatment.

• Prescribe opioid medications carefully and monitor. Unintentional overdose deaths, primarily with opioids, now outnumber traffic fatalities in many states. Individuals with psychiatric illness are overrepresented among those receiving prescriptions for opioids and those taking overdoses. This same trend has been seen in former military personnel. A recent study found that Iraq and Afghanistan veterans with a diagnosis of post-traumatic stress disorder who were prescribed opioids were significantly more likely to have opioid-related accidents and overdoses, alcohol and non-opioid drug-related accidents and overdoses, and self-inflicted and violence-related injuries.

• Improve primary care treatment for depression. Research suggests that patients who die by suicide are more likely to have visited a primary care physician than mental health specialist in the previous month. Programs developed to improve primary care physicians' recognition and treatment of depression could help lower suicide rates.

Also, The Department of Veterans Affairs (VA) has launched, Stand by Them: Help a Veteran, a joint VA-Department of Defense (DoD) outreach campaign that includes a new public service announcement, Side by Side, designed to help prevent suicide among veterans and service members and focuses on the important role family and community play in supporting Veterans in crisis.

Throughout September (Suicide Prevention Month) and beyond, VA and DoD are urging community-based organizations, Veterans Service Organizations, health care providers, private companies and other government agencies to connect Veterans and Service members in need of assistance to the Veterans Crisis Line (1-800-273-8255, press 1).

Overall, Secretary Sebelius says that there is $55.6 million in new grants for suicide prevention programs. "Our message today is one of hope," she said. "The national strategy will bring together the nation's resources, both public and private, in an organized effort to provide life saving services and improve the ability of individuals, friends and family members to recognize the warning signs of despair and take action to save lives."

For more information about how you can be involved in the prevention of suicide, here is a list of links to help you get started:

• To view or order printed copies of the National Strategy for Suicide Prevention and other materials, visit www.samhsa.gov/NSSP.
• To learn more about suicide prevention, visit www.sprc.org.
• To view the U.S. Surgeon General's new "Everyone Plays A Role" PSA, visit http://www.surgeongeneral.gov/
• To view the Department of Veterans Affairs new "Side by Side" PSA, visit http://www.veteranscrisisline.net/materials/spmsupport/files/side-by-side-SD-eng-60-cc.wmv
• Join “Take 5 to Save Lives” at www.take5tosavelives.org, a project of the National Council for Suicide Prevention.