Importance Of Suicide Prevention In Mental Health Transformation
This excerpt provides a strong rationale for making suicide prevention part of mental health system transformation at any level: Suicide Prevention in a Transformed System
What does transformation mean to you who dedicate your lives to preventing the tragedy of suicide?
Transformation is an extremely powerful concept. It suggests fundamental change—an upheaval and reorganization of what we know, what we do, and how we go about doing it. In a transformed system— Recovery will be the expected outcome, so the stigma surrounding treatment will be reduced. Consumers and survivors will act as gatekeepers. They will recognize the warning signs of suicide and be able to encourage people at risk to seek treatment. From a provider’s perspective, mental health care in a transformed system will be closely associated with primary care: Regardless of the setting, providers will have the training and opportunities they need to assess children and adults for early symptoms of behavioral and mental disorders.
There will be parity in insurance compensation because the critical link between mental health and overall health will be commonly accepted. Care will be age appropriate and culturally competent. It will be based on evidence-based practices. It is important to understand that achieving the vision of a transformed system is crucial to suicide prevention…and vice versa. Preventing suicide is, likewise, crucial to Achieving the Promise.
But there are obstacles. Currently, the front-line providers who provide much of our Nation’s behavioral health care have not been adequately prepared and are part of a health care delivery system not organized to serve people at risk for suicide…according to the Surgeon General’s Report on Mental Health, approximately one-half of the adults in the United States who seek mental health care in any given year receive their services in the primary care sector. The Institute of Medicine reports that up to 26% of general medical clinic patients also receive treatment for their alcohol-related disorders in the same primary care setting.
these primary care physicians may not be fully trained to diagnose, treat, or make appropriate referrals for persons with behavioral disorders. They may be unaware of evidence-based practices and advances in the field.
This is where you come in. Approximately 75 percent of the 15,000 to 20,000 calls received by the suicide hotline are non-suicidal. They are calls of concern from family members, seeking information and guidance…calls from consumers themselves, who though distraught, are not yet at the ultimate breaking point.
Importantly, such calls are critical openings into the lives of those who are slipping through the cracks.
With this opening, you have a unique, and tremendous opportunity not only for suicide prevention, but also for overall mental health promotion. Each call you take is an opportunity, not just for prevention, but intervention. The offer to send fact sheets or information on support groups for various disorders is just one small example of how you can maximize the window of time you have with a client to educate them, just a little more.
For most of you, this concept isn’t asking that you do anything new. But, it is asking you to think about what you do, and how you do it, in a new way. Suicide prevention must start long before that final call is made.
A Story of Hope
Earlier this year, I learned about a serviceman at Walter Reed Army Hospital who had stepped back from the brink of suicide to reclaim his life. Joe was faced with a series of challenges that threatened to overwhelm him. He was about to be deployed to Iraq. He had suffered a back injury and had become addicted to his pain medication. He was abusing alcohol. Because of his substance use problems, he was performing poorly at work. His wife was threatening to leave him. Exhausted, distracted and consumed with a feeling of self-disgust, Joe nearly drove his car into a ditch one rainy night. Joe’s life was collapsing around him and he began to talk about suicide. Fortunately, Joe’s wife went to his direct superior, who had likewise noticed the change in Joe’s behavior. She strongly encouraged him to talk to someone trained in suicide prevention and his commanding officer accompanied Joe and his wife to the emergency room for a voluntary assessment. Joe was admitted to a short detox program and a day treatment program. He began taking the correct meds for his pain and learned about controlling stress. He entered therapy with his wife. Joe’s story exemplifies what will become commonplace in a transformed system—Joe is part of a system that provides professional, comprehensive
mental health care at an affordable cost—in other words, care was available to Joe. Joe knew where to find the
care he needed—mental health care was accessible to Joe.




Knowledgeable suicide prevention gatekeepers were present within Joe’s intimate circle. Joe’s commanding officer was unafraid to deal with the subject. Joe had the care and support of his wife. He was able to overcome the stigma that makes people ashamed or afraid to seek help. Finally, Joe was able to find his life…and find the sense of hopefulness that he needed to face life’s challenges.
You encounter people like Joe everyday. Someone’s brother…mother…or child. For their sake, we must accept the challenge and opportunity of transformation to make every door the right door to suicide prevention in our communities. Our National vision for suicide prevention hinges on our ability to encourage all Americans to see suicide as a national public health problem that requires each and every citizen to be part of the solution.
I urge you to use this meeting, to think about how the NSPI Advisory Group and other advocates can advance the suicide prevention agenda and how you can embrace the opportunities of transformation to do the important work of suicide prevention better…and help restore hope to the thousands in need. This will not be easy work, but it is critical to saving the lives of those who, even today, are contemplating suicide. You need no stronger impetus than the realization that today some 85 Americans will take their own lives...just as will happen again tomorrow...and all the days after that…until we put into practice what we know…until we find a way to bring the promise of hope to those who may be considering taking their own lives. Let’s ensure that we keep the momentum going. SAMHSA will continue active leadership and support of National and State suicide prevention activities. Together, we can fight this fight. Suicide is the final, most unforgiving act—self-destruction. Suicide prevention is the counter-act for which we do not want to ask for a second chance. There are 30,000 Americans this year we must convince that tomorrow is a day worth living for. I believe we can.

Thank you.

Remarks by
A. Kathryn Power, M.Ed.
Director, Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
The Importance Of Suicide Prevention In Mental Health Transformation

October 28, 2004
Rockville, MD