Unless we take action now, suicide will shadow the next generation

We call them deaths of despair — and they’re increasing. Recent data show suicide deaths have risen 25 percent over the past 20 years.

The root cause cannot be tied to one problem or one issue, but rather a myriad of factors ranging from social determinants to health-related issues. But, no matter how you break it down, the rise in deaths appear to be grounded in despair and hopelessness.

This makes the new U.S. Centers for Disease Control and Prevention (CDC) data, released today, alarming:

• 1 in 3 teens reports persistent feelings of sadness or hopelessness, according to the most recent annual survey of high school students; and
• 1 in 5 teens has seriously considered suicide, according to that same report.

Among these students, all races and genders seem at risk. But girls are almost twice as vulnerable as boys. And, perhaps most disturbing, one in four lesbian, gay and bisexual students report they have not just thought about suicide — they have actually attempted suicide.  

Paying close attention to these recent trends is particularly important because patterns of risky behaviors, opinions about suicide and traumatic experiences that occur during youth have lasting impacts throughout adulthood. We must do something to address the current need while simultaneously working with families and communities to prevent problems in the next generation.

In Pain in the Nation, we surveyed the field to identify policies and programs that will prevent suicide and drug and alcohol misuse and found many evidence-based approaches, including:

1. Incorporate behavioral health into routine primary care

We must seamlessly integrate behavioral health services — routine screenings, appropriate care and referrals — into the fabric of primary care delivery,  meeting the person’s and family’s needs in the moments they need it most. Well-tested screening tools exist, but most clinical sites don’t use them, and those at risk may not be identified.

2. Offer immediate access to assistance

The CDC lost its funding for a national 24/7 suicide prevention hotline years ago yet policy levers like the 21st Century Cures Act continue to recommend the reauthorization of this program. Restoring funding would create an immediate safety valve for those at risk.

3. Oppose discrimination that elevates risk

Effective school-based initiatives to combat bullying, racism and homophobia exist and should be universally adopted. Behavioral health professionals and trainings should be embedded in schools to better prepare staff to create a culture of well-being.

4. Treat those in crisis

Crisis is a signal that someone needs immediate support. In some instances, the needed support may be related to social or economic need, such as financial hardship; other times, it may be the threat of interpersonal violence.

5. Provide skill- and resiliency-building and conflict resolution opportunities in school and community settings

Several programs — the PROSPER project and Communities That Care—are evidenced-based, and hundreds of schools and communities use them. Yet many others don’t,  either because they don’t know about them or lack the resources.

6. Reduce access to the means most often used in completed suicides

Completed suicides are more likely when a gun is involved, but women and girls are more likely to attempt suicide with drugs. Reducing access to guns and drugs can diminish riskUnless we act, suicide will shadow the next generation.

Putting policy into action means supporting solutions that touch every family, school, health care setting and community.

For example, the Zero Suicide Initiative integrates suicide prevention into primary and behavioral health care. This model, originally adopted by the Henry Ford Health System’s Behavioral Health Services division in 2001, led to an 80 percent reduction in suicide among HMO members.

In addition, The Garrett Lee Smith program uses a “gatekeeper” approach, where adults who interact with tweens and teens help identify concerns. These community and faith leaders and coaches look for signs of mental illness, substance misuse or suicidal ideation.

The adults then connect the young person with community supports. Communities across the nation that implemented the programs had significantly fewer suicides, and one review found the nationwide program helped prevent more than 79,000 suicide attempts from 2007 to 2010.

However, in the face of promising programs and policies, we still have data that show we’re not getting better. We need a true sea change — from the federal government down to our community centers. Everyone can and should play a part.

By coming together and through thoughtful investment, we can ensure our young people enter adulthood and thrive.

The latest and continual drumbeat of data must lead to actual action and policy change.

John Auerbach is president and CEO of Trust for America’s Health, a nonprofit that promotes sound public health policy and advocates for making disease prevention a national priority. Benjamin F. Miller, Psy.D. is the chief strategy officer at Well Being Trust. He previously worked at the Department of Family Medicine at the University of Colorado School of Medicine, where he was the founding director of the Eugene S. Farley, Jr. Health Policy Center and currently remains a senior advisor. Follow him on Twitter: @miller7.