Supporting States in Building Suicide Prevention Infrastructure

The American Foundation for Suicide Prevention (AFSP) and the Suicide Prevention Resource Center (SPRC) are working together this May for Mental Health Awareness Month to raise awareness of a practical and valuable resource for state suicide prevention efforts -- SPRC’s Recommendations for State Suicide Prevention Infrastructure.

Now is the time to draw attention to what your state can do to better address suicide. States moving away from the acute COVID-19 crisis phase and focusing more on long-term recovery allows space for lawmakers and state agencies to place renewed attention on other serious public health problems, including suicide. New data are coming out that are starting to show the potential impact of the pandemic on suicide rates. And thanks in part to the work of suicide prevention advocates across the nation, we’ve seen a lot of progress over the last several years in willingness to talk about suicide and address it through policy and systems changes at the federal, state, and local levels.

Suicide prevention “infrastructure” refers to how a state organizes, funds, implements, and sustains their suicide prevention efforts. The Recommendations for State Suicide Prevention Infrastructure help guide states in applying what we’ve learned about suicide through research to these efforts in a strategic way. AFSP is proud to have served on the Advisory Panel for the Infrastructure Recommendations along with many other experts from state and national organizations, suicide prevention leaders, specialists in state government, and individuals with lived experience. AFSP was well-suited to contribute to this work as its local chapters – mostly led by volunteers directly affected by suicide – deliver and promote education and prevention programs and work directly with state agencies, state coordinators, state and local coalitions, and other community organizations in all 50 states, D.C., and Puerto Rico. AFSP’s Public Policy Office also supports chapters in advocacy efforts and works to advance state suicide prevention infrastructure through legislative and policy solutions.

Suicide prevention infrastructure varies widely across states and can include things like:

• Whether or not a state has dedicated paid staff to oversee suicide prevention efforts
• How much state funding is put toward those efforts (if any)
• Which types of state positions and agencies play a role in suicide prevention
• Whether suicide prevention work is guided by an updated state plan or strategy
• Which (or whether) community organizations and coalitions are involved and working together
• How states collect and analyze data on suicide deaths, suicide attempts, and self-harm behaviors
• How states evaluate and sustain prevention efforts over time

Recognizing a need for guidance in these areas, SPRC brought together experts from state and national organizations (including AFSP), suicide prevention leaders, specialists in state government, and individuals with lived expertise to share their experience and help develop the final Infrastructure Recommendations that reflect current research and practice.

There is much we can learn from states who have already begun using the Infrastructure Recommendations to inspire advancements in suicide prevention infrastructure. “Success Stories from the Field” are featured on the SPRC site and highlight real-life examples of this work, like these from Utah and Colorado. AFSP chapters have also contributed in powerful ways:

• In Illinois: Until 2019, the Illinois Suicide Prevention Alliance operated as an advisory body with no funding. The Alliance consisted of state agency representatives and nonprofits that met quarterly but did not undertake any activities beyond sharing information. The Alliance was also guided by an outdated state plan. After identifying these areas of need, advocates from the AFSP Illinois chapter drafted and supported a bill, which ultimately passed with unanimous support, to create a dedicated suicide prevention position within the Illinois Department of Public Health (“IDPH”) and to require the Alliance to draft an updated state plan. The chapter then led the team that wrote a new state suicide prevention strategy. Since then, the chapter now advocates for full funding for the suicide prevention program within IDPH each budget cycle. With current annual funding, the program now has the resources to implement the new state strategy.
• In Michigan: The AFSP Michigan chapter has worked over the last several years with the state legislature, the Michigan Department of Health and Human Services (MDHHS), and other partners to build leadership, capacity, and collaboration toward a strong infrastructure, including establishing the Michigan Suicide Prevention Commission, a group of multi-sector experts across the state that works with MDHHS and regularly updates the state legislature on the scope of suicide in the state and evidence-informed policy and infrastructure recommendations. This collaboration has resulted in the launch of public awareness campaigns and upcoming revised standards for death scene investigations and clinician licensure.

Our hope is that, by using the Infrastructure Recommendations to identify needs and gaps and to take coordinated action to address them, each state and territory will ultimately have a sustainable foundation for the kind of suicide prevention that makes a difference. Not simply while there is federal grant money available, or for whatever a community can support through fundraising, but ongoing so that evidence-based suicide prevention can persist – even through the ups and downs of ever-changing budget landscapes and public attention.

There are free tools available to help you learn about and use the Infrastructure Recommendations, educate others about them, and start taking action:

• In the archived webinar Building State Infrastructure in Your State, SPRC, AFSP, and NAMI New Hampshire describe the basics of the Infrastructure Recommendations and how they can be useful for your state
• The Summary Recommendations for State Suicide Prevention Infrastructure is a short, sharable document that presents the Infrastructure Recommendations in a nutshell, as well as a place for coalitions or individuals to include their contact information
• A Getting Started Guide can help states take those first steps toward implementing the Infrastructure Recommendations
• SPRC’s annual State and Territorial Needs Assessment examines infrastructure nationwide, and if your state or territory participated, you can contact your state suicide prevention lead to learn more about the unique needs and strengths of your own state or territory
• To help educate legislators and other policymakers, there is a cover letter for state policy makers and a brief video from a former state senator and suicide loss survivor
• AFSP led the development of a talking points document, Using SPRC’s State Suicide Prevention Infrastructure Recommendations, to help advocates prepare for, meet with, and follow up with policymakers on these issues
• AFSP’s State Fact Sheets contain state-specific information about existing leadership structure and laws and can help you make the case for improving infrastructure in your state

We urge you to take action this May for Mental Health Awareness Month to support your state in this work! Get to know who is leading infrastructure efforts in your state – contact your state suicide prevention coordinator (listed on sprc.org/states) and read your state’s current suicide prevention plan (listed on your AFSP State Fact Sheet page) to learn who the main players are and what they’re working on. Connect with your local AFSP chapter to volunteer on their advocacy committee and sign up as a Volunteer Advocate. Attend coalition meetings. Meet with your state and local legislators. And use the resources and tools we’ve highlighted here today and others on the SPRC Infrastructure Recommendations webpage.

Together, we can advance and strengthen state suicide prevention infrastructure nationwide and make sure states are working effectively toward a common goal – saving lives and bringing hope to those affected by suicide.