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  • Changing the Conversation from Suicide to Suicide Prevention: Messages that can Save Lives

    John Draper, Ph.D.

    Lifeline Executive Director

    GLS Plenary

    March 2018

  • Hotlines & Public Health: Promote Awareness & Help-seeking

    “If only the signs were this easy to read” 1-800- LIFENET NYC DMH Anti-stigma campaign, 2000

  • Post-9/11: Disaster Mental Health and Resilience

    Even Superheroes Need Help Sometimes. 1-800- LIFENET, Project Liberty, NY State, 2002

  • Lifeline: Online Messenger Millions of suicide prevention stakeholders across the United States are promoting the Lifeline, with 75% of Lifeline callers first learning of the service from online resources…

    Any search that is suicide related results in a prominently displayed “one box” through our partnership with Google.

    Our partnerships with social media companies reach up to seven million people annually. Lifeline has more “FB fans” than any other suicide prev. organization

    When people in the United States mention suicide to Apple iPhone’s Siri, she refers them to the Lifeline.

  • 2015-2017: Lifeline Web Site Visits








    1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35

    User Overview February 2015 - December 2017


    2016 unique visitors (2.6m) were 22% more than 2015 (2.1m) 2017 unique visitors (4.5m) were nearly 75% more than 2016

  • Lifeline and the Mass Media

  • What is Our Message for This?

  • • Does publicizing warning signs work? • If action step is only Hotlines or Professionals:

    Suicide Prevention is other people’s business!

    • If our efforts are mostly “Safe Messaging”: • Does not intentionally work with media to

    reduce suicide rate (just avoid making it worse)

    • Behavior change = telling people what more they can do is most effective

    • Reactive and endless pursuit of bad actors; how will we know it’s working?

    • Can potentially alienate media as partners in reducing suicide (Give them stories to help their reporting!)

    Limitations of Traditional Suicide Prevention PH Messaging

  • USA National Action Alliance for Suicide Prevention Priority #3One of Top 3 Priorities:

    Change the public conversation around suicide and suicide prevention. The Action Alliance will leverage the media and national leaders to change the national narratives around suicide and suicide prevention to ones that promote hope, connectedness, social support, resilience, treatment and recovery.

  • 750,000 Hospitalizations**

    1,000,000 Attempts Requiring Medical Attention**

    2,600,000 Suicide Attempts**

    12,600,000 Seriously Considered Suicide**

    44, 965 Suicides*

    SLIDE FROM DR. DeQuincy LeZine, Prevention Communities Inc. Primary author, The Way Forward, publication of the NAASP Source: * National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. (2009). Web-based Injury Statistics Query and Reporting System (WISQARS). Available from: And CDC YRBS, 2016 **Substance Abuse and Mental Health Services Administration, Results from the 2015 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-42, HHS Publication No. (SMA) 11-4667. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2016. And CDC YRBS, 2016.

    The Tale of Tragedy and Misery

  • 750,000 Hospitalizations**

    1,000,000 Attempts Requiring Medical Attention**

    2,600,000 Suicide Attempts**

    12,600,000 Seriously Considered Suicide**

    38,364 Suicides*

    Changing the Conversation

    44,965 Suicides

  • NAASP Response to CDC Report on Suicide Rates

    “The CDC data remind us that there is more we must all do to prevent suicide in our communities. However, it is important to be aware of data that indicates suicide prevention is effectively occurring daily, in ways that are rarely finding headlines. For every one person who tragically dies by suicide in the U.S., there are approximately 278 people who have moved past serious thoughts about killing themselves, and nearly 60 who have survived a suicide attempt, the overwhelming majority of whom will go on to live out their lives. These untold stories of hope and recovery are the stories of suicide prevention, stories which are informing the Action Alliance’s efforts to prevent more suicides every day.” Excerpt from NAASP Press Release, 4/22/2016

  • NAASP: Framework for Successful Messaging

  • Public Health Messaging Reduces Deaths

    • 43% reduction in heart disease deaths since 1969 (over half due to prevention efforts)

    • 23% decline in cancer death rates since 1991 (over half deaths can be prevented via behavior change)

  • Key Message #1 Primary Audience: Potential Helpers

    “YOU can take actions that can help prevent suicide.”

  • Samaritans

  • Teaching Community Members Can Save Lives

    GLS Evaluations, 2007-2010: Counties with GLS programs had sig. lower suicide rates for ages 10-24 the year after GLS activities were implemented. Impact on suicides did not persist after a year. Authors: staff turnover, need for refresher gatekeeper training, focus on comprehensive programming fades over time. Walwrath, C, Garraza, LG, Reid, H, Godston DB & McKeon, 2015

  • What does the public think about suicide prevention?

    2015 Harris Poll, by NAASP, AFSP, ADAA: • Most (94%) believe suicide is preventable • Most (93%) would do something if

    someone close to them had suicidal ideas • Most believe mental health conditions like

    depression increase suicide risk • Most believe mental health care is helpful • Most (55%) have been affected by suicide

    (someone close died by suicide, had thoughts of suicide, etc.)

  • The Public. Almost 50% of Americans identified barriers that stopped them from trying to help someone at risk for suicide, such as (Harris poll 2015):  fear that they would say or do something to

    make things worse rather than better, and  not knowing how to find help for a person in


    Public and MH Professionals: What Can I Do to Help?

    The Professionals.  NY State survey (2014) of 1585 providers,

    64% little or no suicide prev training NAASP Survey (2013) of 30,000 MH

    professionals. Approximately half reported not enough skills, training or supports to work with suicidal persons

  • What Help Do Suicidal Persons Need?

    Australia survey of 127 persons with LE of suicide, 33 mental health professionals. Suicidal persons wanted: • To have their suicidal thoughts taken

    seriously • To be asked about suicide directly • To be listened to nonjudgementally and be


    Professionals rated more highly taking action.

    Pirkis on Report to beyondblue, IASP, 2017

  • What do Suicidal Persons Want?

    WHO Study, Bruffaerts, et al, 2011(over 55,000 persons in 21 countries with recent suicidal thoughts/behaviors) Of 45%-51% attempt survivors that did not receive care:

    • 58% said “low perceived need” for care • 40% wish to handle the problem alone • 15% structural barriers (financial, distance) • 7% stigma

    Gould, Munfakh, Kleinman & Lake, 2012 (376 suicidal Lifeline callers from 16 centers interviewed) Of the 48% not linking to care after the call, over half said that the problem was not severe enough and could be managed on their own without treatment

  • Self-Help and Suicide Prevention

    Gould et al, SLTB, 2012: “Our findings emphasize the necessity of respecting and targeting individuals’ strong need for self-efficacy to optimize their receipt of help….The strategy of enhancing and promoting self-care and informal care has long been employed by crisis counselors, and our findings suggest that this should continue….”

  • First Line Coping Strategies

    • Spirituality/religious practices 18 % • Talking to someone/companionship 14 % • Positive thinking 13 % • Using mental health system 12 % • Considering consequences to

    people close to me 9 % • Using peer supports 8 % • Doing something pleasurable 8 % • Protecting myself from means 5 % • Doing grounding activities 4 % • Considering consequences to

    myself/fear 2 % • Doing tasks to keep busy 2 % • Maintaining sobriety 1 %

    198 adults with history of mental illness/treatment and at least one suicide attempt were asked:

    “If your darkness and despair escalated to actual thoughts of suicide, what has helped you in the past to not take that action?” (write up t