Promoting Mental Well-Being is a Vital Part of Comprehensive Suicide Prevention

May 28, 2024 | Caitlin Langhorne Griffith, Ali Maffey

Each year, there are nearly 50,000 deaths by suicide and an estimated 1.6 million suicide attempts in the United States. Those statistics don't account for the compounded grief and loss experienced by impacted families, workplaces, schools, and communities. In October 2023, ASTHO, CDC, the Center for Law and Social Policy, and Mental Health America launched the Public Health's Role in Mental Health Promotion and Suicide Prevention Framework (Framework), which underscores how public health can improve mental well-being and prevent suicide. Public health's role in mental health promotion and suicide prevention is rooted in understanding that mental and physical health are both essential to the overall health of every person. Mental health promotion is one aspect of suicide prevention. Both areas share some risk and protective factors in common, and they share similar prevention strategies. These strategies focus on improving mental health and preventing suicide for all people, in every community, in the settings where they live, learn, work, and play.

The White House recently launched the 2024 National Strategy for Suicide Prevention (the National Strategy), a 10-year, comprehensive plan to prevent suicide and suicide attempts. The National Strategy calls on leaders to demonstrate the ability to "Care, Connect, and Collaborate" when implementing effective policies and services that span the prevention spectrum. The Framework and the National Strategy define clear roles and responsibilities for public health and partners to properly equip communities to define solutions based on input from those most impacted.

Integrating Community-Based Prevention

Community-based prevention efforts focus on changing the conditions that increase risk or protect people from experiencing mental health challenges or contemplating suicide. Mental health and suicide share some risk and protective factors, such as a person's economic condition, past experiences of trauma or adverse childhood experiences (ACEs), and how connected they feel to others and their community. 

Strategies from ASTHO's Framework align with many of those outlined in the National Strategy, such as promoting protective environments, strengthening skills and knowledge related to help-seeking, resilience, problem-solving, and coping, and reducing stigma through community education. 

Additionally, ASTHO and the National Strategy recommend strengthening economic supports by creating stable housing, increasing access to affordable childcare, and increasing paid leave for caregivers. Improving the environment where people live is also crucial; public health can provide critical insight into land use decisions (e.g., creating green spaces and offering transportation alternatives). Lastly, ASTHO and the National Strategy both recommend a community-based prevention system that reduces access to lethal means to prevent suicide by firearm. Each of these components helps promote the mental health and well-being of all people to reduce their risk for suicide.

Increasing Access to Quality Data

High-quality data is imperative for developing robust mental health promotion and suicide prevention programs by monitoring relevant outcomes and the risk and protective factors associated with these outcomes. To support this effort, ASTHO, in coordination with CDC, developed the Suicide Indicator Explorer (Explorer). This interactive, visual tool helps health agencies identify potential measures for suicide prevention programs. The Explorer can spot suicide burden, patterns of risk and protective factors for suicide, data-driven prevention strategies that align with CDC's Suicide Prevention Resource for Action, data for evaluating programs, and disproportionately affected populations. Similarly, incorporating lived experience and community member input will increase overall quality data, resulting in better policies, programs, and community connections.

Embedding Health Equity Approaches

Integrating health equity throughout public health programming, funding, and policies related to suicide prevention and mental health promotion is critical. The Framework emphasizes the importance of public health, addressing social and institutional equities through policy and practice, which includes—but is not limited to—involving people with lived experience and communities most impacted in decision-making and implementing culturally responsive and linguistically relevant programs.

Additionally, public health plays a pivotal role in ensuring that all communities have access to healthcare and healing systems, including Western medicine, spiritual, and cultural care with providers who look and speak like the communities they serve. Although anyone can experience suicide risk, certain populations are disproportionately affected (e.g., youth and young adults, people who identify as LGBTQ+, veterans, people with disabilities, people with mental health conditions, and people with ACEs). By tailoring interventions to fit the needs of those disproportionately affected populations, public health can remain grounded in health equity and ensure that mental health and well-being are at the center of each person's health.

Moving Forward: Multi-Sector Partnerships

Public health plays a clear role in helping to maintain strong partnerships, ensuring lived experience voices are at the forefront, and promoting safe and supportive communities. For instance, the Puerto Rico Department of Health coordinated across all 78 municipalities to train their communities on how to reduce suicide-related stigma. By creating training materials for various community partners, first responders, and those most affected by the risk of suicide, Puerto Rico reached their entire island without overextending their team. At the same time, the Vermont Department of Health partnered with agencies like their state’s Department of Mental Health and hospital system to include suicide prevention in emergency departments and improve screening, reduce access to lethal means, and increase follow-up care. These examples help demonstrate the importance of engaging a variety of partners.

By implementing these strategies, public health can help prevent the risk of suicide before it occurs and mitigate the immediate and long-term harms of suicidal behavior. A public health approach to mental health promotion and suicide prevention includes addressing the multiple factors that influence these conditions as well as engaging multiple sectors, such as community-based organizations, healthcare systems, businesses, and schools. Each sector has a part to play in promoting mental health and preventing suicides, and public health is well-positioned to support all communities by creating a sense of well-being and helping them thrive.