The Surgeon General's Call To
Action
To Prevent Suicide, 1999
At a Glance: HHS Initiatives
Addressing Suicide/Risk Factors
COMMITMENT TO A NATIONAL SUICIDE PREVENTION STRATEGY
(NSPS)
The Substance Abuse and Mental Health Services
Administration (SAMHSA) in conjunction with the Surgeon General and other DHHS agencies
will bring together a group of suicide prevention experts, advocates, and practitioners
later this year (1999) to outline the scope of work for the continued development of a
National Strategy for the Prevention of Suicide and to create a time line for its progress
and completion. The group will identify component substeps across many
areasconceptual framework, measurable objectives, necessary resources and ways to
monitor progress, and policy gaps and models. Providing a detailed listing of activities
and outlining a sequence for completion of each will advance the already remarkable
progress seen in national suicide prevention activities in the past several years.
The Centers for Disease Control and Prevention
(CDC), working with OHS and other public and private partners mentioned above utilizing
the SAMHSA-led blueprint, will complete a draft document for consensus building around the
national strategy in early 2000. CDC is currently planning to work with SPAN on a series
of large regional meetings to consider and refine this draft. This regional work will
culminate in a large national meeting to finalize the National Strategy to Prevent
Suicide. The NAPS will include implementation plans for the "best practices" use
of the Strategy in communities around the Nation. The CDC currently has requested $2.7
million in FY2000 for these activities.
In addition to continuing to bring high
visibility to the issue of suicide as a major public health problem that can be prevented
through a variety of national and international presentations, the Surgeon General will
utilize his good offices to bring together health professional organizations, educators,
health care executives, and managed care clinical directors to discuss gaps in scientific
knowledge of effective mental illness interventions and everyday practices in order to
improve the health of recipients of care and to decrease the incidence of suicide.
The Health Resources and Services Administration
(HRSA) and DHHSs Regional Health Administrators (RHAs) are developing structured
programs for the education and continuing education of primary care providers in
depression and anxiety assessment and intervention.
HRSA's internal Mental Health/Substance Abuse
Workgroup is currently engaged in identifying training materials and resources relating to
depression as an intersecting diagnosis for violence, substance abuse, suicide and other
mental health problems. Information on the materials and resources will be made available
to entities providing training for HRSA grantees such as State Primary Care Associations,
Geriatric Education Centers, Area Health Education Centers, and Education Training Centers
for HIV/AIDS.
HRSA will also emphasize working with
non-federal safety net providers such as "Meals on Wheels" and workers in Home
and Community-Based Medicaid Waiver programs and other nontraditional community workers
which often have ties to safety-net programs and providers.
PARTNERSHIPS WITH OTHERS
The Office of Public Health and Science (OPHS) has
facilitated a partnership whereby the Ronald McDonald House Charities is providing funding
to the American School Counselors Association for the reproduction and distribution to
every high school counselor in the country of a special episode of "In the Mix,"
the national weekly PBS teen series. Funded by the Corporation for Public Broadcasting,
the special "Depression: On the Edge" examines ways to destigmatize and detect
adolescent depression and prevent suicide.
The Ronald McDonald House Charities continues to
prioritize youth suicide prevention and has funded 25 educators/school
counselors to be a part of the development of the NSPS believing that their practical and
first hand experience as youth change agents on the front-line of working with kids
provided valuable insights into honest and realistic prevention possibilities.
Mrs. Gore and the Surgeon General are working
with the Ad Council, MTV, the American Psychological Association and other private-sector
companies and organizations to develop a national media campaign aimed at eliminating the
stigma that often is associated with mental illness which, when it hinders people from
seeking the help they need, can lead to suicide. It is anticipated that the campaign will
be launched in late 1999/early 2000 in conjunction with the release of the Surgeon
Generals Report on Mental Health.
Solvay Pharmaceuticals, the
largest financial cosponsor of the SPAN-led Reno conference, provided sponsored
scholarships for registration and travel of survivors and attempters of suicide.
Additionally, they provided public relations assistance for the conference in Reno as well
as the national press conference in Atlanta following Reno. Solvay supports SPAN's ongoing
advocacy and political will work in an effort to see that a U.S. National Strategy to
Prevent Suicide is completed.
The states of California, Georgia, Minnesota,
Nevada, and Tennessee have all committed resources and emphasis to develop a State
Strategy to Prevent Suicide using demographics that fit their state suicide profile and
following the Reno model for strategy development. California, Georgia, Nevada, North
Carolina, and Tennessee have begun state SPAN organizations to
advance, through advocacy and political will, the suicide prevention process in their
states.
ONGOING FEDERAL INITIATIVES
Center for Injury Prevention and Control, CDC
A case-control study that is examining possible risk
factors for suicide, including alcohol use, exposure to previous suicides, and residential
mobility that might lessen opportunities for developing social networks.
Convening national conferences to exchange
information about research and prevention strategies (including the Suicide Prevention
Advocacy Network conference held in Reno in October 1998 and the American Indian/Alaska
Native Community Suicide Prevention and Network conference held in San Diego in November
1998).
Supporting four investigator-initiated suicide
prevention research projects as well as a number of projects being conducted by CDC
scientists in the area of surveillance and risk factor identification.
Development of a national suicide prevention
center, the Suicide Prevention Research Center, at the Trauma Institute, University of
Nevada School of Medicine.
Continued support for a Native American suicide
prevention center.
Evaluation of the effectiveness of current
suicide prevention programs, including two interventionsone with youth in New York
and one with older persons in South Carolina.
National Institutes of Health/National Institutes of
Mental Health
Overall, NIH has requested $26.5 million for
suicide-related research in FY00, focusing on improving the treatment, diagnosis, and
prevention of mental disorders through its intramural and extramural research programs.
Suicide prevention is a priority for the NIMH, as the majority of suicide victims have at
least one mental disorder, and suicidal behaviors, including thoughts and attempts,
frequently occur among persons with mental disorders such as depression, personality
disorder and schizophrenia.
Funding a $7.3 million research project to
examine the prevalence of mental health problems in a representative sample of 10,000
Americans age 15 and older. The survey will address issues of vital importance to public
health, providing information on the duration of various mental disorders, the kinds of
disability they produce, the links between socioeconomic status and mental health, and the
relationship between types of mental illness and use of services. The study is funded
through a grant to Harvard University, led by epidemiologist Dr. Ronald Kessler. In part,
the survey will make it possible to identify trends, a vital tool for planning and
assessing public and private mental health services, as well as insurance coverage. The
research project will contribute to the World Mental Health 2000 initiative of the World
Health Organization (WHO). WHO, in turn, will use this information to increase health
policymakers recognition of mental disorders as a priority in public health
prevention and intervention efforts worldwide.
In fiscal year 1998, NIMH support for suicide
research projects was approximately $17 million. Study topics ranged from neurobiological
correlates of suicidal behavior, to treatment studies of patients who are suicidal, as
well as postmortem studies that investigate possible precursors and risk factors. The age
groups studied extend from childhood to later life, and include high risk groups such as
American Indians and Alaskan Natives, homeless and runaway youth, and older white males.
Monitors progress in suicide research through
the Suicide Research Consortium. The Consortium coordinates program development in suicide
research in the Institute, identifies gaps in the scientific knowledge base on suicide
across the life span, and stimulates and monitors NIH extramural research on suicide
through scientific workshops.
Substance Abuse and Mental Health Services
Administration
The Safe Schools/Health Students Initiative, a collaborative effort
among the Departments of Health and Human Services, Education and Justice, through which
grants totaling more than $180 million a year will be awarded to approximately 50 local
educational authorities and their mental health and law enforcement partners to promote
healthy childhood development and prevent violent behaviors.
The School Action Grant Program, a school violence prevention
effort launched by the Centers for Mental Health Services in collaboration with the Center
for Substance Abuse Treatment, that will award $5.7 million a year to encourage
communities to promote healthy childhood development and prevent youth violence and
substance abuse through the use of programs and practices shown to be effective.
Agency for Health Care Policy and Review
In June 1999, awarded four-year, $2.3 million grant to the Kaiser
Permanente Center for Health Research in Portland, Oregon, to find a more effective way of
treating depression in teenagers seen in managed care practicesthe source of health
care for most Americans.
Youth Partners in Care, an AHRQ-funded project is examining the
impact of a program designed to improve the outcomes of mental health care for children in
managed care practices, and reduce their families' stress, by educating them and their
primary care physicians about depression treatment.
Health Resources and Services Administration
Girl Neighborhood Power: Building Bright Futures for Success is a 5-year
effort to demonstrate how state and local agencies, organizations, businesses and
communities can work together to improve the health, education and well-being of
adolescent girls. The Girl Neighborhood Power effort is intended to help girls with
physical activity, nutrition, health education, abstinence, mental health, social
development, community service and future careers.
HRSAs Maternal and Child Health Bureau has sponsored
Bi-Regional Adolescent Suicide Prevention Conferences to strengthen and expand state and
local efforts to develop partnerships and systems of care for preventing youth suicide.
The proceedings include conference presentations and state by state data on youth suicide
deaths.
For more information, please contact the following
offices:
Centers for Disease Control and Prevention, National Center for Injury Prevention and
Control
www.cdc.gov/ncipc
404-639-3286
Health Resources and Services Administration
www.hrsa.dhhs.gov
301-443-1989
National Institute of Mental Health (NIMH) Suicide Research Consortium
www.nimh.nih.gov/research/suicide.htm
301-443-4536
Substance Abuse and Mental Health Services Administration
www.samhsa.gov
301-443-8956
Office of the Assistant Secretary for Health/Surgeon General
www.surgeongeneral.gov
202-690-7694
Last revised: January 4, 2007
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