Community Efforts to Promote Mental Health and Prevent Suicide

Community-led suicide prevention efforts play a vital role in the nation’s response to promoting mental health and preventing suicide. On Mental Health Action Day (May 18) and every day, local educators, health professionals, and prevention staff can use EDC’s Community-Led Suicide Prevention Web toolkit to save lives where they live.

“Across the country, people are really motivated to reduce suicide in their communities. With the Community-Led Suicide Prevention toolkit, we wanted to provide a resource that could help those dedicated teams make real, sustainable change,” says EDC’s Julie Ebin, who led the development of the toolkit.

Often inspired by the death of a loved one, community-led suicide prevention efforts can coordinate action to save lives. But they also often face challenges, ranging from unstable funding sources to member burnout, that threaten their sustainability and impact.

Recently, Ebin discussed the state of community-based suicide prevention efforts with three experts: Caroline Snyder, director of injury and violence prevention with the National Association of County and City Health Officials (NACCHO); Jonah Cunningham, president and CEO of the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDDD) and executive director of the National Association for Rural Mental Health (NARMH); and Anne Marie Snell, executive director for the St. Lawrence County (NY) Health Initiative, Inc. The following conversation has been edited for length and clarity.

Julie Ebin: So much of prevention is focused on how to prevent suicide once you get somebody in the door to a clinic or a hospital or an emergency department. Where do non-clinical, community-based programs fit into the broader national landscape of suicide prevention efforts?

Caroline Snyder: State or national efforts can provide the overall strategic direction, and they can help push the field in one way or another. But those top-down efforts can introduce silos. For instance, public health is over here, and behavioral health is over there. Community-based and community-driven efforts can break down those silos. If community leaders are leading the efforts, they can identify what’s working, what’s not working, and how they need to change.

Anne Marie Snell: Our organization has a mission to measurably improve the health of Saint Lawrence County residents, and residents of the north country region, through collaborative community efforts. So, we know our community, and we know the specific issues and the unique challenges that we might experience. I see the national efforts as a valuable resource for local coalitions who have an idea, but who don’t know where to search for that evidence base or don’t even know where to begin.

Jonah Cunningham: To Caroline‘s point, we can set strategies at the national level. And as Anne Marie said communities are doing the tactics. That requires a lot of creativity. And I often think about how a lot of local suicide prevention activities often lack the words suicide prevention in their titles. Having a strong community presence, teaching coping mechanisms, promoting financial stability—these are all evidence-based forms of suicide prevention, even if we don’t formally call it that.

Ebin: What do you see as the advantages of suicide prevention activities coming directly from the community?

Snell: One benefit is that we look like the people who are in need of the resources. Many of our coalition members are connected deeply to the community. We have those connections in veterans’ groups, in the local rod and gun club, in schools. That gives us the ability to get to an event or to speak to communities we want to reach.

Cunningham: Anne Marie made a great point about the need for authenticity within those community efforts. If local people are leading these efforts, there’s much less of a chance that they will alienate the community they’re trying to serve.

Ebin: In developing the toolkit, we tried to focus on providing people with practical resources that they could use. What kinds of resources do you think community-led suicide prevention efforts need right now?

Snyder: In a recent National Association of County and City Health Officials (NACCHO) fielding of the Suicide, Overdose, and Adverse Childhood Experiences Prevention Capacity Assessment Tool, about two-thirds of the local health departments surveyed reported that they had no designated staffing for suicide prevention. Not full time, not part time. And only about 1 in 10 had sustainable funding for suicide prevention. There’s also a lot of learning to do amongst the workforce about how to implement effective suicide prevention efforts. They need to better understand the evidence base, and they need to learn how to adapt effective programs, how to craft effective messaging, and how to address stigma in a concrete way.

Snell: Training is a top priority for us. And then funding. We couldn’t do this without having a little bit of seed funding. Our coalition members are passionate about this work, but they also all have full-time jobs.

Cunningham: Data, or a data dashboard, can help programs figure out what their community’s current needs are or how they are moving the needle. Proactive or upstream metrics could help you find certain populations or certain community members who might need a little extra outreach before they are in crisis.

Snell: That resonates with me. About two years ago, we unfortunately had some very high-profile suicides in our community. One of them was my nephew. And it forced us to ask ourselves, what are we doing with all the data that we have?

Ebin: I’m sorry to hear about your loss, Anne Marie, but I appreciate you sharing that with us. So many people are doing this work because they have experienced loss. How do you make sure that all kinds of people who have a stake in these efforts are at the table?

Snell: We have over 20 people who want to be on our local suicide awareness coalition, but we still don’t have representation from every sector that we’d like to see. So we’ve asked one of our coalition members to help us recruit in particular sectors, such as from funeral homes, law enforcement, and schools.

Snyder: I think step 1 is knowing who you should be looking for and knowing who is most affected in the community. That gets to Jonah’s point about data at the local level. We talk about at-risk populations, vulnerable populations, marginalized populations—so you need to understand your community first to make sure that you are engaging them and having the most impact. And it’s not always about gathering surveillance data. Sometimes you learn the most just by listening to community members and by hearing about what challenges and barriers they’re experiencing.

Ebin: Being mindful that this work is a marathon and not a sprint, what advice would you have for communities or practitioners who are doing this work? How can they be successful over the long term?

Cunningham: When making the case for prevention, I think it’s important to reach a person’s head, heart, and feet. You want to appeal to their head using logic and statistics. You want to appeal to their heart by sharing stories. And most importantly, you want to appeal to their feet by telling them what they can do to make a difference. You have to know what your specific ask is, and then be able to justify it.

Snyder: Suicide is so closely linked to other behavioral health issues and conditions. You can’t do suicide prevention in a vacuum. To be more effective, we have to root our efforts in addressing the underlying risk and protective factors.

Snell: I always go back to the idea of collaboration. You really are not alone in these efforts. So whether you have 20 people at the table or 2, you have to remember that there are other people out there in your community who are concerned about this issue. Maybe they’re even doing something about it, too. So my advice is to be mindful of the resources and expertise that are happening right around you. Those partners can lift up the work that you’re already doing.

To learn more about the 7 elements of effective community-based suicide prevention, use this toolkit.