Suicide prevention is always a priority, especially during times of economic decline, illness, and uncertainty. But what are some of the best strategies for success? If you know someone whom you suspect is harboring thoughts of ending their life, what do you say? If you want to send a message within your community, what are some of the best methods of suicide prevention public messaging? Research has some answers.
Donna Littlewood et al. (2019) examined the issue of suicide prevention in a qualitative study involving a review of quality practices as described by clinicians.[i] They extracted data from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) database, which examined suicides among people receiving mental health services.
They found five themes which illustrated positive practices, helping to:
- promote safer environments,
- develop stronger relationships with patients and families,
- provide timely access to tailored and appropriate care,
- facilitate seamless transitions, and
- establish a sufficiently skilled, resourced, and supported staff team.
Littlewood et al. noted, however, the importance of context as a distinguishing feature, explaining that failure to deliver adequate care can be seriously harmful to patients. As an example, they note that failure to develop strong relationships with those providing care, or failure to facilitate timely access to care appropriate for the situation are linked with disastrous results, such as suicide.
In addition to discussing the best practices, Littlewood et al. recognized that their study also demonstrated the value of allowing clinicians to share their experience, which can enhance quality improvements within the field of mental healthcare.
Stephen Platt and Thomas Niederkrotenthaler (2020) reviewed best practices in suicide prevention programs.[ii] They examined and analyzed the effectiveness of 13 different types of interventions that have become part of national suicide prevention programs. They found strong evidence supporting the effectiveness of what they describe as structural interventions, such as restrictions on access to railways, tall buildings, and bridges, as well as restrictions on accessing pharmacological agents.
But they found only weakly supportive evidence of the effectiveness of a wide variety of other types of programs and interventions, including everything from training and education of primary care physicians, to firearm access restrictions, to settings-based programs in workplaces, schools, and communities.
Platt and Niederkrotenthaler conclude that major improvements are needed in bridging the knowledge gap about methods of effectively intervening to prevent suicide. They describe this gap as surprising, but also disturbing. As an example, they observe the dearth of evaluation studies examining how substance misuse programs impact suicidal behavior, noting the importance and prevalence of alcohol and other substances abused by individuals who also exhibit suicidal behavior.
Public Awareness Campaigns
Joie Acosta et al. (2017) examined some of the best types of public messaging strategies for preventing suicide, specifically evaluating California’s ‘Know the Signs’ Media Campaign.”[iii] They developed a checklist of “best practices for suicide prevention communication campaigns,” and then used the checklist to evaluate California's Know the Signs (KTS-M) suicide prevention mass media campaign. KTS-M endeavored to educate others about the red flags of suicide, and how to talk with at-risk individuals at risk in order to educate them about resources that are available.
Their results showed that the KTS-M campaign was among the best that they had evaluated. Core campaign messages include: Pain isn’t obvious; Suicide is preventable; Know the warning signs of suicide; Find the words to talk to someone you are concerned may be at risk; and You are not alone in helping that person—there are resources available.
Best Practices for Best Results
We are working as a society to find the best ways to identify risk factors, treat relevant symptomology, and ultimately prevent suicide. By sharing information among community members, clinicians, and families touched by the heartbreak of losing a loved one through suicide, we can continue to strive to reach out to those at risk to prevent loss of life.
[i] Littlewood, Donna L., Leah Quinlivan, Jane Graney, Louis Appleby, Pauline Turnbull, Roger T. Webb, and Navneet Kapur. 2019. “Learning from Clinicians’ Views of Good Quality Practice in Mental Healthcare Services in the Context of Suicide Prevention: A Qualitative Study.” BMC Psychiatry 19 (November). doi:10.1186/s12888-019-2336-8.
[ii] Platt, Stephen, and Thomas Niederkrotenthaler. 2020. “Suicide Prevention Programs: Evidence Base and Best Practice.” Crisis: The Journal of Crisis Intervention and Suicide Prevention, Suicide and Suicide Prevention From a Global Perspective, 41 (Suppl 1): S99–124. doi:10.1027/0227-5910/a000671.
[iii] Acosta, Joie, Rajeev Ramchand, and Amariah Becker. 2017. “Best Practices for Suicide Prevention Messaging and Evaluating California’s ‘Know the Signs’ Media Campaign.” Crisis: The Journal of Crisis Intervention and Suicide Prevention 38 (5): 287–99. doi:10.1027/0227-5910/a000446.