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Suicide Prevention Research in a Rapidly Changing World

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As I sit down to write this blog, the COVID-19 pandemic continues to have a widespread impact, and we’re all trying to figure out our “new normal.” For some, figuring out the new normal has been especially difficult, and that’s something for all of us to consider during September, which is National Suicide Prevention Awareness Month. It’s such an important time to share what we know about suicide prevention and consider how we can further this knowledge to those in need.

At NIH’s National Institute of Mental Health (NIMH), we’ve been asking ourselves: What have we learned about suicide risk and prevention during the pandemic? And how should our research evolve to reflect a rapidly changing world?

Addressing Disparities

Over the last few years, people have been concerned about the pandemic’s impact on suicide rates. So far, data suggest that the overall suicide rate in the U.S. has remained steady. But there is concerning evidence that the pandemic has disproportionately affected suicide risk in historically underserved communities.

For example, data suggest that people in minority racial and ethnic groups experienced greater increases in suicidal thoughts during the pandemic [1]. Additional data indicate that suicide rates may be rising among some young adult racial and ethnic minority groups [2].

Structural racism and other social and environmental factors are major drivers of mental health disparities, and NIMH continues to invest in research to understand how these social determinants of health influence suicide risk. This research includes investigations into the effects of long-term and daily discrimination.

To mitigate these effects, it is critical that we identify specific underlying mechanisms so that we can develop targeted interventions. To this end, NIMH is supporting research in underserved communities to identify suicide risk and the protective factors and effective strategies for reducing this risk (e.g., RFA-MH-22-140, RFA-MH-21-188, RFA-MH-21-187). There are important lessons to be learned that we can’t afford to miss.

Building Solid Foundations

The pandemic also underscored the urgent need to support youth mental health. Indeed, in December 2021, U.S. Surgeon General Dr. Vivek Murthy issued the Advisory on Protecting Youth Mental Health, calling attention to increasing rates of depression and suicidal behaviors among young people. Crucially, the advisory highlighted the need to “recognize that mental health is an essential part of overall health.”

At NIMH, we know that establishing a foundation for good mental health early on can support a person’s overall health and well-being over a lifetime. In light of this, we are investing in research to identify effective prevention efforts that can help set kids on positive mental health trajectories early in life.

Additionally, by re-analyzing research investments already made, we are looking to see whether these early prevention efforts have meaningful impacts on later suicide risk and mental health outcomes. These findings may help to improve a range of systems—such as schools, social services, and health care—to better support kids’ mental health needs.

Improving and Expanding Access

The pandemic has also shown us that telehealth can be an effective means of delivering and increasing access to mental health care. The NIMH has supported research examining telehealth as a tool for improving suicide prevention services, including the use of digital tools that can help extend provider reach and support individuals at risk for suicide.

At the same time, NIMH is investing in work to understand the most effective ways to help providers use evidence-based approaches to prevent suicide. This research helps inform federal partners and others about the best ways to support policies and practices that help prevent suicide deaths.

In July, the Substance Abuse and Mental Health Services Administration (SAMHSA) launched the 988 Suicide & Crisis Lifeline, a three-digit suicide prevention and mental health crisis number. This service builds on the existing National Suicide Prevention Lifeline, allowing anyone to call or text 988 to connect with trained counselors and mental health services. Research supported by NIMH helped build the case for such lifelines, and now we’re calling for research aimed at identifying the best ways to help people use this evolving crisis support system

Looking Ahead

With these and many other efforts, we are hopeful that people who are at risk for suicidal thoughts and behaviors will be able to access the evidence-based support and services they need. This National Suicide Prevention Awareness Month, I’d like to issue a call to action: Help raise awareness by sharing resources on how to recognize the warning signs for suicide and how to get help. By working together, we can prevent suicide and save lives.

References:

[1] Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 pandemic – United States, April and May 2020. McKnight-Eily LR, Okoro CA, Strine TW, Verlenden J, Hollis ND, Njai R, Mitchell EW, Board A, Puddy R, Thomas C. MMWR Morb Mortal Wkly Rep. 2021 Feb 5;70(5):162-166.

[2] One Year In: COVID-19 and Mental Health. National Institute of Mental Health Director’s Message. April 9, 2021.

Links:

988 Suicide & Crisis Lifeline (Substance Abuse and Mental Health Services Administration, Rockville, MD)

Substance Abuse and Mental Health Services Administration Treatment Locator (SAMHSA)

Help for Mental Illnesses (National Institute of Mental Health/NIH)

Suicide Prevention (NIMH)

Digital Shareables on Suicide Prevention (NIMH)

Digital Shareables on Coping with COVID-19 (NIMH)

NIMH Director’s Messages about COVID-19 (NIMH)

NIMH Director’s Messages about Suicide (NIMH)

Note: Dr. Lawrence Tabak, who performs the duties of the NIH Director, has asked the heads of NIH’s Institutes and Centers (ICs) to contribute occasional guest posts to the blog to highlight some of the interesting science that they support and conduct. This is the 16th in the series of NIH IC guest posts that will run until a new permanent NIH director is in place.

6 Comments

  • Janet Rumble says:

    If you don’t start checking medication history especially the use of antidepressants which can cause increase in suicidal ideation and severe anhedonia You are remiss in researching how many suicides are caused by the use of this medication. We need to stop pretending it’s not the medication.

    • RBreen says:

      It’s not the antidepressants. “Most people struggling with suicidal thoughts and behaviours (roughly 60%) do not receive treatment.” Bruffaerts R, Demyttenaere K, Hwang I, et al. Treatment of suicidal people around the world. Br J Psychiatry 2011; 199: 64–70.

      NIMH and SAMHSA have also been telling us: “only 20% of children who need care access mental health services.”

      That said, persons started on antidepressants should be followed closely during the first two weeks of treatment and antidepressants can be dangerous for people with bipolar disorder.

  • Nancy Breen says:

    The New York Times recently published an article as well as did a podcast (August 30) on this subject of youth mental health. The article indicated that CBT (and the subset known as DBT) appear to be effective therapies. What is NIH doing (with taxpayer money, I might add) to address this issue with respect to these therapies? I’m hearing a lot of talk, but very little action. I am deeply concerned about this problem and the systemic racism that permeates so much of our society. You need to get off your medical bandwagon and start listening to the community leaders, spiritual leaders, and others on the front lines of this problem. Academic interest alone will not solve this problem.

  • Deborah says:

    Are any services available to young adults that may not have health insurance? If so, how are these services communicated widely to young adults? There is a great need!!!! Our youth were struggling pre pandemic and continue to struggle post pandemic.

  • Fahmida pathan says:

    NIMH has taken a good initiative to prevent suicide. I really appreciate their efforts.

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