Satcher took a major step toward reducing the national suicide rate last month when he unveiled a set of broad goals and objectives at a press briefing in Washington, D.C. The report is the first installment of a national strategy for suicide prevention that Satcher announced nearly two years ago (Psychiatric News, September 3, 1999).

About 30,000 people commit suicide and 650,000 attempt suicide annually, according to Satcher. Suicide is the third-leading cause of death for individuals aged 10 to 24 and the eighth-leading cause of death for all age groups, according to the report.

Satcher said, "The public-health approach in this national strategy represents a rational and organized way to marshal prevention efforts and ensure they are effective. It is especially fitting that we release these goals and objectives in May, which is Mental Health Month, and shortly before National Suicide Prevention Week, May 6 to 12," said Satcher at the briefing.

Key components of the public health approach involve developing a national reporting mechanism for suicides and suicide attempts, reducing risk factors, and strengthening protective factors such as strong interpersonal relationships, said Satcher.

He emphasized that effective treatment of psychiatric and substance abuse disorders are a central aspect of the national suicide prevention strategy. "The vast majority of suicide victims have a diagnosable mental illness or substance abuse disorder, or both," he said.

Among the goals of the national strategy are improving access to mental health and substance abuse services, eliminating stigma, and increasing the number of states with parity legislation. Satcher praised the 32 states that have already enacted parity laws.

To reduce the suicide rates, physicians, teachers, health care professionals, clergy, and other professionals must be trained to recognize the warning signs of suicide and make appropriate referrals. "Suicide is everyone’s business, and every member of society has a role to play," said Satcher.

When one person attempts or commits suicide, the emotional trauma and guilt affect everyone who knows the person, including family members, friends, teachers, and coworkers, Satcher noted.

APA President Daniel Borenstein, M.D., said in a press release that the national strategy for suicide prevention is "a landmark public health effort that for the first time will unite major sectors of our society to address the tragedy of suicide."

He continued, "We are in complete agreement with the Surgeon General that more must be done to promote the relationship between suicide and mental disorders. We strongly support the need to educate both lay and professional groups about the warning signs of mental disorders and specific signs of suicide."

These were among other goals that Satcher mentioned:

• Provide funding to states to help them implement and evaluate suicide-prevention programs.

• Promote efforts to reduce access to lethal means of suicide, especially firearms.

• Improve media reporting of suicidal behavior, mental illness, and substance abuse.

• Promote and support research on suicide and suicide prevention.

"We need more research to understand the complexities of suicide and evaluate the programs that are implemented to know what works and what doesn’t," said Satcher.

He mentioned a community-based suicide education and prevention program in the Air Force that has cut the suicide rates among Air Force personnel in half. "The program, which began in the mid-90s, has reached nearly all 250,000 active-duty personnel and thousands of civilian personnel," said Satcher.

The Air Force has begun collaborating with other branches of the military to develop and implement similar suicide-prevention policies and programs.

Carl Bell, M.D., vice chair of APA’s Committee on Psychiatric Aspects of Violence, told Psychiatric News at the briefing, "I commend Satcher for his clear vision and leadership on suicide prevention. I agree that we need a large-scale holistic approach because suicide is a complex issue. We must tailor programs to fit the specific needs of different segments of our population."

Bell, a member of an Institute of Medicine committee that is studying the scientific basis for suicide and vulnerability of specific populations, urged psychiatrists to participate in community outreach and start screening programs in schools and jails, for example.

The next phase of the national suicide prevention strategy will be to design specific activities for implementing the goals and objectives announced last month.

A summary of the national goals and objectives and resource materials are posted on the National Strategy for Suicide Prevention Web site at www.mentalhealth.org/suicideprevention/index.htm. ▪