Data-driven research on the implementation and effectiveness of suicide prevention policies and programs
Suicide has emerged as a dire public health emergency in recent decades, with death rates increasing approximately 36% from 2000 to 2021, according to data from the Centers for Disease Control and Prevention (CDC). More than 48,000 Americans died by suicide in 2021, which translates to one death every 11 minutes. Suicide deaths occur across all races, ethnicities, and age groups.
Suicide is preventable. However, to address the growing crisis effectively, a multifaceted, multidisciplinary approach involving government agencies, health systems, research institutions, and advocacy organizations is essential. RTI International is building upon decades of experience researching mental health policies and programs to improve national suicide prevention efforts.
Crisis Hotlines for Suicide Prevention
Over the past several decades, many organizations have developed crisis hotlines to provide 24/7, confidential support to people experiencing suicidal thoughts or emotional distress. In 2022, a three-digit dialing code—988—was introduced to connect any phone in the United States with the 988 Suicide and Crisis Lifeline, a hotline funded by the Substance Abuse and Mental Health Services Administration that was launched in 2005.
To increase understanding of suicide risk, researchers are using emerging technology to sort through large datasets produced by these hotlines. In a 2022 study funded by CDC, experts at RTI leveraged machine learning algorithms that use natural language processing to pinpoint mentions of firearm violence and suicide in Crisis Text Line conversations. This study found a spike in crisis conversations mentioning firearms following the 2022 mass shooting in Uvalde, Texas.
Zero Suicide Initiative
Nearly 30% of individuals who died by suicide between 2000 and 2013 received health care services in the 7-day period before their death. The Zero Suicide initiative provides a framework for transforming health care systems to improve the quality and safety of care for individuals at increased risk for suicide.
Researchers at RTI conducted a study, funded by the Office of the Assistant Secretary for Planning and Evaluation, to evaluate the implementation and sustainability of Zero Suicide in eight health care systems across the United States. Findings indicate that a systems-wide commitment to prioritizing the identification and care of individuals at risk for suicide is essential for the successful implementation of the initiative.
Predictors of Suicide Risk
Researchers have identified individual- and community-level factors—such as exposure to family violence or a history of mental health or substance use disorders—that contribute to increased suicide risk. However, evidence shows that these classic warning signs may not manifest in all populations, including Black youth. From 2009 to 2019, the percentage of Black youth who considered suicide, made a suicide plan, and attempted suicide all increased, highlighting the need to improve our understanding of the trajectory of suicide for this population.
In a 2021 statement published in JAMA Pediatrics, researchers from RTI, the Nationwide Children’s Hospital, and the University of North Carolina at Chapel Hill emphasized the need for a “ground zero” approach for research and action on suicide prevention among Black youth. This approach focused on funding research that examines culturally relevant risk factors and the developmental trajectory of suicidal ideation and behavior among Black youth, while also engaging trusted community organizations and institutions in prevention efforts.
RTI will continue to support research on population-level risk factors for suicide, which are critical for the development of culturally relevant prevention programs and policies.