Changing the Conversation

September is an important month for suicide prevention. World Suicide Prevention Day (September 10, 2016) and National Suicide Prevention Week (September 5–11, 2016) provide us with opportunities to encourage people who are struggling with suicidal behavior to seek help, to assist friends, family members, and helping professionals in supporting individuals who are struggling with suicidal thoughts and behaviors, and to expand the numbers of people who are actively engaged in suicide prevention and mental health promotion.

But these goals require more than just shouting our messages from the rooftops or designating a day, week, or month to focus attention on suicide prevention. They require an informed and serious conversation. For far too long, conversations about suicide—if they took place at all—have focused on hopelessness, despair, and inevitability. But both research and practice show us that suicide can be prevented. We know that individuals at risk for suicide can overcome this risk and live healthy, productive, and fulfilling lives. And we know that applying evidence-based practices and delivering comprehensive and integrated prevention programs can reduce the rates of suicides in populations. September provides us with an opportunity to rededicate ourselves to changing the conversation about suicide from one of despair and inevitability to one of hope, health, and resilience. We can frame our messages to encourage hope. We can remind people at risk that there is hope. We can remind friends and families that there is help. And we can remind clinicians and other care providers that they can help.

But to change the conversation, we must have a conversation. Shouting from the rooftops might get us heard, but it is not a conversation. In recent years, we have made tremendous progress engaging in conversations with those who can inform our efforts because of their direct experience with suicidal behaviors and because they are personally invested in our goals. These include the survivors of suicide loss, whose efforts helped create the field of suicide prevention, build the public suicide prevention infrastructure, and establish many of the private organizations whose efforts are essential to advancing our knowledge and practice as well as maintaining and expanding the prevention system. In more recent years, persons with lived experience have added their voices to the conversation—voices that offer a moral imperative for suicide prevention as well as a perspective that research alone cannot provide.

This is not the first time that changing a conversation was necessary to make a major public health breakthrough. In the 1950s, cancer was the “c-word.” We did not talk about it. We could not cure it. Once we started talking about cancer, we started dedicating resources to its prevention and treatment. While the struggle against cancer is far from over, the number of people who now survive cancer and lead healthy and productive lives seems like a miracle to those of us who remember earlier times. Others will remember the early 1980s when the fight against AIDS was mobilized with the slogan “Silence=Death”—a direct reference to the fact that we must acknowledge a problem before we can solve it.

The voices and experience of clinicians and other caregivers have taught us much about the potential impact of best practices, effective training, and systems transformation on health care outcomes. This is evidenced by the tremendous success of Zero Suicide, which is based on the Henry Ford Health Care System’s Perfect Depression Care model. Henry Ford was the first health care system to use a Robert Wood Johnson Pursuing Perfection grant to apply the recommendations of the Institute of Medicine’s Crossing the Quality Chasm: A New Health System for the 21st Century to behavioral health care. We are now applying to suicide prevention many of the principles that health care systems use to work toward zero infections, zero medical errors, and zero patient falls.

Those of us in the field of suicide prevention will be doing much this September. We’ll be reaching out, speaking out, and lighting candles. But let’s also use September to renew our dedication to continuing to reframe and expand the national conversation about suicide and, by doing so, turn hurt to hope, pain to promise, and anguish to action.

For More Information

For ideas, information, and resources on observing World Suicide Prevention Day, National Suicide Prevention Week, and National Suicide Prevention Month, see SPRC’s Suicide Prevention Month Ideas for Action.