The NCSL Blog


By Emily Heller

An American adult dies every 12 minutes by suicide. Rising rates have lifted suicide to the 10th leading cause of death in 2015.

Man with worried look; credit Centers for Disease ControlTo address this growing public health issue, the Centers for Disease Control and Prevention (CDC) recently issued a compilation of seven strategies in “Preventing Suicide: A Technical Package of Policy, Programs and Practices.” This new technical package, designed as a resource for state leaders, is informed by the best available scientific evidence about what works to prevent suicide.

This resource comes at a critical moment. Rates of many other leading causes of death, including heart disease and stroke, declined over the past several decades. Suicides are on the rise, however, with rates increasing by more than 25 percent between 2000 and 2015, according to the CDC. Among veterans and other military personnel, the rate increase was even higher, jumping nearly 50 percent between 2003 and 2008.  

In addition to human costs, a recent study found that after factoring in underreporting, suicide attempts and deaths cost an estimated $93.5 billion nationally in 2013, primarily in lost productivity.

NCSL recently published a piece in State Legislatures magazine that discusses steps states have taken to prevent suicide. The article highlights efforts in Utah, where the SafeUT Crisis Text and Tip Line smartphone app has shown early success in lowering the state youth suicide rate.

And Utah isn’t alone. State lawmakers across the country are exploring policy options to prevent this growing public health issue. At least 32 states and the District of Columbia considered legislation this year related to suicide prevention. Legislation dealt with issues such as preventing suicide in schools and colleges, establishing suicide prevention hotlines, and developing or funding suicide prevention programs.

The CDC hopes that the technical package will be a resource to help states as they grapple with this issue. Strategies include:

  • Creating protective environments. Policies or programs that aim to promote protective environments—or environments that address risk factors for suicide—have shown evidence of success in reducing suicide and suicide attempts. These may include encouraging safe storage of medications and firearms, or restricting access to suicide “hotspots,” such as bridges and railway tracks. Policies targeting the social environment may support programs that foster awareness of suicide risk factors and available resources. 
  • Strengthening economic supports. Historically, suicide rates rose during economic recessions and times of instability, and fell during times of economic growth and low unemployment rates. State leaders may wish to consider policies that promote household financial security and stable, affordable housing. For example, several studies suggest that increasing the amount and duration of unemployment benefits may help prevent suicide.
  • Strengthening access and delivery of care. Nationally, fewer than half of Americans who reported having serious thoughts of suicide received any mental health care in 2015, making access to services a major issue for many communities. State mental health parity laws, which require insurance policies to provide mental health coverage equivalent to that provided for other health conditions, were associated with an estimated 5 percent decline in suicide rates, according to a recent study. Other policies addressing access may focus on provider recruitment and retention, or extending the reach of existing providers through telehealth services.  
  • Teaching coping and problem-solving skills. State leaders may wish to support programs that teach youth skills such as problem-solving, emotional regulation, help seeking and coping. Similarly, lawmakers may support programs for parents that aim to enhance parenting skills and promote healthy relationships. Research shows that these types of programs can promote youth resilience and reduce risk factors for suicide, such as depression and substance abuse.
  • Identifying and supporting people at risk. Other policy options center on identifying vulnerable individuals and connecting them with treatment and other supports. For example, establishing or supporting suicide prevention hotlines may be an effective way to help people in crisis. This strategy also includes gatekeeper training—training teachers, coaches, faith leaders, health care providers and others to recognize risk factors for suicide and help those at risk access support services. 

The CDC’s National Violent Death Reporting System collects comprehensive data on suicide deaths across 40 states, the District of Columbia and Puerto Rico, which leaders can use to understand the scope of the problem and which groups are most affected in their communities. The CDC hopes to expand this system to cover additional states.

Emily Heller is a research analyst in NCSL’s Health program.

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.