Sustaining Success

June 02, 2017

News Type:  Director's Corner
Author:  Jerry Reed, PhD, MSW, SPRC Director, Education Development Center, Inc.

Suicide Prevention Resource Center (SPRC) staff have had the privilege of working with Garrett Lee Smith Memorial Act (GLS) grantees for the past 12 years. We have watched them grow in number, sophistication, and experience. During this same period, however, we have also watched suicide rates rise, both for adolescents and adults. We know that there are reasons for this—risk factors associated with the Great Recession and other economic changes, the aging of the baby boom generation, and a dramatic rise in opioid misuse. The increase in the suicide rate sometimes raises the question among some about whether we can, in fact, prevent suicide. I think we need to occasionally remind ourselves, the press, and the public that, in fact, we can and we are. As our efforts and infrastructure continue to strengthen, our results will likely follow.

Two studies on the impact of GLS programs spoke to the very real promise of suicide prevention. They found that counties in which GLS programs were implemented had significantly lower rates of suicide and suicide attempts among young people than similar counties without GLS programs. The fact that the rate of suicide among adults did not decline may suggest that these decreases were due to the activities of the GLS programs, given that GLS programs target young people and not adults. The authors estimated that the GLS program resulted in 79,000 fewer suicide attempts and 427 fewer suicide deaths in the years 2008 to 2011 and 2007 to 2010, respectively.

Unfortunately, these decreases in rates were not sustained after the first year of implementation.  The authors suggested that the failure to sustain these results was not due to the programs themselves, but rather a fading of adherence to and focus on program implementation, possibly due to staff turnover and a lack of refresher trainings. A decline in effectiveness associated with weakened implementation has been noted in evaluations of other prevention programs, including the U.S. Air Force Suicide Prevention Program, which is an exemplar of the comprehensive approach to suicide prevention.

The takeaway is that sustained success requires sustained effort, and a sustained effort requires a sustained investment, including a commitment of resources. Maintaining a successful program is less challenging than implementing a new program. I would argue that it is also less expensive than the costs of suicidal behaviors. The ultimate means of sustaining success is making permanent changes in the arenas in which suicide prevention takes place. Zero Suicide exemplifies this approach by transforming health care systems so that no one at risk for suicide falls through the cracks. I am confident that by building on the knowledge and skills we have gained, and by making an investment of time and resources, we will be able to start rolling back the suicide rate and meet our collective goal of reducing the annual rate of suicide 20 percent by 2025.

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