Govt. Boosts Investment In Suicide Prevention

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the awarding of 37 grants to support suicide-prevention efforts aimed primarily at youth.

The grants, which total $9.7 million in the program's first year, will support suicide-prevention programs on college campuses, the development and implementation of statewide or tribal youth suicide prevention and early intervention strategies, and the creation of a national resource center to provide assistance in the development, implementation, and evaluation of suicide-prevention programs.

The grants were authorized by the Garrett Lee Smith Memorial Act, which was named in memory of the son of Sen. Gordon Smith (R-Ore.); he suffered from bipolar disorder and committed suicide at age 21 (Psychiatric News, October 15, 2004).

“Young people can be lost in the deep darkness of mental illness, and these programs will help find sufferers and get them life-saving help,” Smith said in a statement issued with the grant announcement.

The grants come amid a steady but slow decline in youth suicide since 1993. In 2004 approximately 900,000 teenagers made plans to commit suicide during their worst or most recent episode of major depression, and 712,000 attempted suicide during such an episode, according to a SAMHSA report on 12- to 17-year-olds based on data from the 2004 National Survey on Drug Use and Health.

The report defines major depressive episode as a period of at least two weeks in which a person experienced a depressed mood or loss of interest or pleasure in daily activities and met at least five of the nine DSM-IV-TR criteria for depression.

Programs Have Wide Reach

Twenty-two colleges and universities are receiving grants ranging from $25,000 to $75,000 a year for up to three years, with an equivalent match from the organization applying for the grant. The continuation of the grants, according to SAMHSA, is subject to availability of funds and progress achieved by the recipients.

The University of North Carolina at Chapel Hill is receiving $63,669 to develop a “train-the-trainer” model so that campus personnel who are not mental health specialists but regularly interact with students can be trained to be aware of students' mental and physical health status, according to SAMHSA.

A $68,088 grant will be used at Vanderbilt University to develop training programs for students and campus personnel so that they will be able to respond more effectively to students with mental or behavioral health problems. The program will develop educational materials and seminars on identifying risk factors for suicide, decreasing high-risk activities, and promoting the search for help.

Other SAMHSA grants will provide up to $400,000 for 14 state and tribal suicide-prevention programs aimed at youth; these grants include $400,000 for the Arizona Department of Health Services' effort to provide a continuum of prevention, early intervention, and postintervention services. The program's strategies include gatekeeper training for educators, first responders, behavioral health professionals, and youth leaders.

A $399,921 grant to the Texas Department of State Health Services will be used to help fund a public/private partnership to train health, school, and community representatives to identify and refer at-risk youth.

The national suicide resource center that the grant program is also supporting will be created and operated by the Education Development Center Inc. in Newton, Mass.

Grant Support Greatly Needed

The grants come as psychiatrists raise concerns about a drop in antidepressant prescriptions written for teenagers, since many experts credit these medications with lowering suicide rates in recent years (Psychiatric News, September 2). Controversial black-box label warnings about possible increased suicide risk may have led to the drop in prescriptions written by general practitioners, who treat the largest number of depression cases, said Lois Flaherty, M.D., a lecturer in psychiatry at Harvard Medical School and chair of APA's Council on Children, Adolescents, and Their Families.

“The fact that we still have pretty high rates of suicide among young people would suggest that we are not doing everything we can to prevent this,” Flaherty noted. “Suicide is a relatively rare occurrence, but still it is preventable, which is why it is so tragic to have a young person die.”

Depression is overwhelmingly associated with youth suicide, although other factors can be present, Flaherty said. Risk factors include substance abuse and violence—either exposure to violence or violent behavior.

Suicide is also the third-leading cause of death among 15- to 24-year-olds. In 2001, 3,971 suicides were reported in this group, according to SAMHSA. American Indians and Alaska Natives had the highest rates of suicide in this age group. A report in the May 2004 Journal of School Health stated that 16 percent of ninth- to 12th-grade students in Bureau of Indian Affairs high schools with 10 or more students attempted suicide one or more times in the 12 months preceding the survey.

Grant programs are most effective, Flaherty said, when they help individuals identify signs of depression in themselves and in others. Other leading prevention approaches are aimed at ensuring that treatment is readily available and destigmatizing requests for suicide-prevention help.

More information on SAMHSA's suicide-prevention efforts is posted at<www.mentalhealth.samhsa.gov/suicideprevention/>.▪