National Pathways for Suicide Prevention and Health Services Research

Abstract

Context In 2012, the National Action Alliance for Suicide Prevention (Action Alliance)'s Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs, and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Evidence acquisition Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Evidence synthesis Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Conclusions Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide.

Major Physical Health Conditions and Risk of Suicide

“…5 This is consistent with data showing that more than 80% of individuals make a healthcare visit in the year before suicide, and nearly 50% have a visit within 4 weeks of their death. 6 …”

Symptoms of Anxiety and Depression and Suicidal Behavior in College Students: Conditional Indirect Effects of Non-Suicidal Self-Injury and Self-Compassion

“…When considering community resources, the extent to which individuals have access to necessary clinical care, including both mental and physical health services, may decrease risk for suicide and suicide-related behavior (Ahmedani & Vannoy, 2014). Broadly, in the United States, increased rates of federal spending on mental health care are associated with trends toward decreased risk for suicide across the lifespan (Tondo, Albert, & Baldessarini, 2006).…”

Racial/Ethnic Differences in Health Care Visits Made Before Suicide Attempt Across the United States

“…Research on where and when to target interventions was identified as a primary objective of the prioritized research agenda. (6, 7) Evidence suggests that over 80% of individuals make healthcare contacts before suicide. (8) Although rates of suicidal behavior vary across racial/ethnic groups,(9–12) there are limited data on when and where different groups use services prior to a suicide attempt.…”