Suicide is a serious public health problem. In 2009, suicide was the 10th leading cause of death in the
United States (2nd leading cause of death for adults ages 25-34, and the 3rd leading cause of death for
youth ages 15-24.). A person dies by suicide about every 14.2 minutes in the United States, and it is
estimated that for every person who dies by suicide, more than 30 others attempt suicide.
In 1999, the US Surgeon General released A Call to Action to Prevent Suicide which resulted in the
development of the National Strategy to Prevent Suicide. On September 10, 2012 a
revised National Strategy for Suicide
Prevention (NSSP) was issued. The revised strategy emphasizes everyone's role in protecting friends, family members,
and colleagues from suicide. The National Strategy was revised to reflect major developments in suicide prevention,
research, and practice during the past decade, including: an increased understanding of the link between suicide and
other health issues, new knowledge on groups at increased risk, evidence of the effectiveness of suicide prevention
interventions, and increased recognition of the value of comprehensive and coordinated prevention efforts.
The Defense Suicide Prevention Office (DSPO), which is part of the Department of Defense's Office of the Under Secretary
of Defense for Personnel and Readiness, oversees all strategic development, implementation, centralization, standardization,
communication and evaluation of DoD suicide and risk reduction programs, policies and surveillance activities. To reduce the
impact of suicide on Service members and their families, DSPO uses a range of approaches related to policy, research, communications,
law and behavioral health. DSPO works with the Army, Navy, Air Force, Marine Corps, Coast Guard and National Guard Bureau to
support our Service members and strengthen a resilient and ready force. DSPO strives to help foster a climate that encourages
Service members to seek help for their behavioral health issues. DSPO has developed a guide (Supporting Military Families in Crisis,
20 Jul 13) which provides military family members with information on suicide warning signs and risk factors, actions to take
when a family member is in crisis, and available resources to promote a healthy lifestyle and build a resilient family.
The National Suicide Prevention Initiative (NSPI) is a multi project effort to
reduce suicide led by the Substance Abuse and Mental Health Services
Administration's Center for Mental Health Services. One of its projects is the
National Suicide Prevention Lifeline which is a 24-hour, toll-free suicide
prevention service available to anyone in suicidal crisis. 1-800-273-TALK (8255).
To ensure veterans with emotional crises have round-the-clock access to trained
professionals, the Department of Veterans Affairs (VA) is partnering with the
National Suicide Prevention Lifeline to operate a national suicide prevention hotline
for veterans. Veterans can call 1-800-273-TALK (8255) and press "1" to reach the
VA hotline, which will be staffed by mental health professionals in Canandaigua,
N.Y. who will work closely with local VA mental health providers to help callers.
Primary care providers play a significant role in identification and treatment of
patients with an elevated suicide risk. Information is provided below to assist primary
care providers in this role.
Table of Contents
- VA/DoD Clinical Practice Guideline for Assessment and Management of
Patients at Risk for Suicide, Jun 13
A Resource Guide for Implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) 2007 Patient
Safety Goals on Suicide
Developed by Screening for Mental Health, Inc. to facilitate implementation of the Joint Commission patient safety goal on suicide.
National Suicide Prevention Lifeline: After An Attempt, A Guide for Medical Providers in the Emergency Department Taking
Care of Suicide Attempt Survivors, DHHS Substance Abuse and Mental Health Services Administration, 2006.
Provides quick tips to enhance Emergency Department care for people who have attempted suicide, and also provides
information on patient discharge and resources about suicide for medical professionals, patients, and their families.
- American Psychiatric Association (APA) Assessment and Treatment of Patients With Suicidal Behaviors Practice Guideline
- Best Practices Registry (BPR) For Suicide Prevention
(The BPR for suicide prevention is a collaboration between the Suicide Prevention Resource Center
(SPRC) and the American Foundation for Suicide Prevention (AFSP). It is funded by the
Substance Abuse and Mental Health Services Administration (SAMHSA). The purpose of the
BPR is to identify, review, and disseminate information about best practices that address
specific objectives of the
National Strategy for Suicide Prevention.)
- Approaching the Suicidal Patient, American Family Physician
Vol 68 No 9, ! Nov 03
Written to try to help family physicians prevent suicide by providing a strategy for assessing risk factors and recommending
interventions that fit the existing level of risk.
Air Force Guide for Managing Suicidal Behavior Strategies, Resources and Tools, 2004.
Developed to help Air Force mental health staff deliver high-quality, evidenced-based care to suicidal individuals.
Screening for Suicide Risk: A Systematic Evidence Review for the U.S. Preventive Services Task Force, Agency for Healthcare
Research and Quality, May 04. Systematic review of the literature regarding whether screening for suicide risk in primary
care results in decreased morbidity, mortality, or both.
- US Preventive Services Task Force (USPSTF) Screening for Suicide Risk, May 04
- Preventing Suicide - A Resource Guide for General Physicians,
World Health Organization (WHO), 2000
This booklet is one of a series of resources prepared as part of WHO's Suicide Prevention Campaign (SUPRE).
- Evaluation and Treatment of Patients with Suicidal Ideation.
American Family Physician, 56(6), 15 Mar 99
Provides guidelines for primary care providers in evaluating and treating patients with suicidal ideation.
Policies and Directives
- OTSG/MEDCOM Policy Memo 13-037, Policy Guidance for the Department of Defense Suicide Event Report (DoDSER) Program, 8 Jul 13 (Requires CAC for access.)
- Army Directive 2010-01, Conduct of AR 15-6 Investigations
into Suspected Suicides and Requirements for Suicide Incident Family Briefs, 26 Mar 10
- Army G1, Suicide Prevention Web Page
- USAPHC Suicide Prevention Resources Web Page
Army G1, Army Suicide Prevention - A Guide for Installations and Units, 15 Mar 08
- AR 600-63, Army Health Promotion, Rapid Action Revision 7 Sep 10
(Paragraph 4-4 Suicide Prevention and Surveillance)
- DA Pam 600-24, Health Promotion, Risk Reduction, and Suicide Prevention, Rapid Action Revision 7 Sep 10
- Navy Personnel Command, Navy Suicide Prevention Program Web Page
- Navy and Marine Corps Public Health Center (NMCPHC), Suicide Prevention Web Page
- Marine Corps Community Services (MCCS) Suicide Prevention Web Page
- BUMEDINST 6520.2, Evaluation and Disposition of Patients Presenting with Suicidal Ideation or Behavior, 7 Mar 11
- OPNAV Instruction 1720.4A, Suicide Prevention Program, 4 Aug 09
- Marine Corps Order (MCO) 1720.2, Marine Corps Suicide Prevention Program (MCSPP), 10 Apr 12
- MARADMIN 658/12, Call to Action for Preventing Marine Suicides, 16 Nov 12
- MARADMIN 580/12, Reporting Requirements ICO Department of Defense Suicide Event Report, 11 Oct 12
- MARADMIN 524/12, Never Leave a Marine Behind Annual Suicide Prevention Training and Master Training Team Requirements, 20 Sep 12
Brochures and Fact Sheets
Other Related Information
- DSPO Guide, Supporting Military Families in Crisis, 20 Jul 13 (The guide, prepared by the Defense Suicide Prevention Office, provides military family members with information on suicide warning signs and risk factors, actions to take when a family member is in crisis, and available resources to promote a healthy lifestyle and build a resilient family.)
- Reserve Affairs, Reserve Component Suicide Postvention Plan: A Toolkit for Commanders, May 12 (The toolkit was developed to help unit leadership respond to a suicide within their command. It provides insight and guidance for supporting the unit, dealing with families, and connecting with the community at large.)
- RAND Report, The War Within: Preventing Suicide in the U.S. Military, 2011
(Written at the request of the Assistant Secretary of Defense for Health Affairs, the report contains information on the epidemiology of suicide; reviews
of scientific evidence and suicide prevention activities; a summary of funding and responsibilities within the services; an assessment of service prevention
programs; and a number of specific recommendations for suicide prevention.)
- Department of Defense Suicide Event Reports (DoDSER) Annual Reports
- Web-based System Helps DoD Track Suicides,
US Medicine, Aug 10
- Final Report of
the DoD Task Force on the Prevention of Suicide Among Members of the Armed Forces, Aug 10
- Report of the Blue
Ribbon Work Group on Suicide Prevention in the Veteran Population, 30 Jun 08
- Congressional Research Service (CRS) Report, Suicide Prevention Among Veterans, 5 May 08
- Army G1, Suicide Prevention Commanders Toolkit
Education and Training
- Military Suicide Research Consortium (MSRC is part of an ongoing strategy to integrate and synchronize U.S. Department of Defense and civilian efforts to implement a multidisciplinary research approach to suicide prevention.)
- Defense Suicide Prevention Office (DSPO) (DoD oversight authority for the strategic development, implementation, centralization, standardization, communication, and evaluation of DoD suicide and risk reduction programs, policies, and surveillance activities to reduce the impact of suicide on Service members and their families. Resources include DSPO Guide, Supporting Military Families in Crisis, 20 Jul 13.)
- Veterans Crisis Lane (To ensure veterans with emotional crises have round-the-clock access to trained professionals, the Department of Veterans Affairs (VA) is partnering with the National Suicide Prevention Lifeline to operate a national suicide prevention hotline for veterans. Veterans can call 1-800-273-TALK (8255) and press "1" to reach the VA hotline, which will be staffed by mental health professionals in Canandaigua, N.Y. who will work closely with local VA mental health providers to help callers.)
- VA Mental Illness Research, Education and Clinical Center (MIRECC) on Suicide and Suicidality in Veterans (MIRECCS were established by Congress with the goal of bringing best practices in mental health care into the clinical settings of the VA. They conduct research and produce clinical educational programs.)
- Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) Suicide Prevention Web Page
- Army Behavioral Health, Suicide Prevention Web Page
- Army Reserve Suicide Prevention Web Page
- CDC, Suicide Prevention Web Page
- National Institute of Mental Health Suicide Prevention Web Page
- National Library of Medicine MedLine Plus Suicide Web Page
- MEDCOM Directory of Suicide Prevention and Related Web Sites, Jun 02 (List of government agencies, voluntary associations, and private organizations that provide suicide prevention or information and resources to the general public and/or healthcare professionals.)
- National Suicide Prevention Lifeline (A 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. 1-800-273-TALK (8255). The National Suicide Prevention Lifeline grant is one component of the National Suicide Prevention Initiative (NSPI), a multiproject effort to reduce suicide led by the Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services. )
- Suicide Prevention Resource Center (SPRC) (The SPRC was created in 2002 to fulfill Goal 4.8 of the National Strategy for Suicide Prevention, which called for “the development of a technical assistance and resource center to build capacity for states and communities to implement and evaluate suicide prevention programs.” SPRC is supported by a cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA))
- American Association of Suicidology (A non-profit organization which promotes research, public awareness programs, public education, and training for professionals and volunteers. In addition, AAS serves as a national clearinghouse for information on suicide.)
- American Foundation for Suicide Prevention
(A non-profit organization exclusively dedicated to understanding and preventing suicide through research and education, and to reaching out to people with mood disorders and those impacted by suicide.)
- American Psychological Association Suicide Web Page
- Injury Control Research Center for Suicide Prevention (ICRC-S) (ICRC-S is a collaboration of the University of Rochester Medical Center and the Education Development Center that promotes a public health approach to suicide prevention through a collaborative process of research, outreach, and education. Its goal is to draw suicide prevention directly into the domain of public health and injury prevention and link it to complementary approaches to mental health.)
- Mental Health America Suicide Web Page(Mental Health America (formerly known as the National Mental Health Association) is a nonprofit organization dedicated to helping all people live mentally healthier lives.)
- National Action Alliance for Suicide Prevention
- National Alliance on Mental Illness (NAMI) Suicide Web Page (NAMI is “the nation’s largest grassroots mental health organization dedicated to improving the lives of persons living with serious mental illness and their families.”)
- Recommendations for Reporting on Suicide (Recommendations for the media developed by leading experts in suicide prevention and in collaboration with several international suicide prevention and public health organizations, schools of journalism, media organizations and key journalists as well as Internet safety experts.)
- Suicide Awareness Voices of Education (SAVE)(A non-profit organization that was one of the nation's first organizations dedicated to the prevention of suicide and was a co-founding member of the National Council for Suicide Prevention.)
- Stop A Suicide Today(A program of Screening for Mental Health, Inc. which teaches how to recognize the signs of suicide in family members, friends and co-workers. It emphasizes the relationship between suicide and mental illness and the notion that a key step in reducing suicide is to get those in need into mental health treatment.)
- Working Minds (Working Minds provides tools and networks to workplaces to assist with suicide prevention, intervention, and postvention with three strategies: establish a workplace suicide prevention network; provide state-of-the art training; and change the culture of suicide in the workplace)
- TAPS (Tragedy Assistance Program for Survivors (TAPS is a non-profit organization that is a front line resource for all who through war, illness, accident or suicide have lost a loved one serving in the Armed Forces. Its comprehensive services include a national network of peer-based emotional support, case work assistance, crisis intervention, and grief and trauma resources.)
- The American Legion, Suicide Prevention Web Center