Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide

You Say Prevention, I Say Treatment: The Nomenclature of Suicide Prevention Part II

Does prevention have to happen before suicidal behavior occurs?

Part II of II

In my last post, I presented three stages of prevention: primary, secondary, and tertiary. Each stage of prevention takes place at a different point in time in relation to suicidal behavior - before suicidal behavior, as suicidal behavior occurs, or following suicidal behavior.

Three levels of prevention interventions also exist: indicated, selective, and universal.

An indicated intervention, as is somewhat implied by its name, is focused on individuals who have a risk factor for suicide. These interventions are often one-on-one and involve interactions between an individual and a health or mental health service provider.

A selective intervention is focused on high-risk groups, and includes such activities as screening for suicide risk in a juvenile justice population or offering a support group for individuals with depression.

A universal intervention is focused on a community or similarly large population group and would include such activities as constructing a barrier on a bridge or and educational campaign.

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Do any of these levels may look more like treatment than prevention? One's perspective, as I said last week, may be influenced by the point at which you may see prevention occurring. Does prevention have to happen before suicidal behavior occurs, or is there something to be said for a mode of prevention which happens following suicidal behavior?

Each level of intervention is less resource-intensive than the one before it, so the political, social, or otherwise environmental will to take on any of these interventions varies depending on a number of factors.

Mental health practitioners might have a favorite approach, which I would imagine is most often an indicated intervention like therapy. Public health practitioners most likely would favor universal interventions like educational campaigns.

In a comprehensive suicide prevention plan, indicated, selective, and universal interventions need to occur. Are there implications of having professionals from differing backgrounds trying to work together to prevent suicide?

I've noticed a lot of willingness and interest for folks to take on media campaigns, including using social media and other Web 2.0 technologies. What's so interesting about that particular type of intervention? How do our feelings about the different prevention interventions influence our willingness to engage in them?

Copyright 2009 Elana Premack Sandler, All Rights Reserved

Elana Premack Sandler, L.C.S.W., M.P.H., is a public health social worker specializing in violence and injury prevention and adolescent health promotion.

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