Authorize

As suicide is both a public health issue and a mental health issue, suicide prevention activities may fall under the responsibility of a number of different state-level departments and agencies, and may also be conducted by many other government and non-government organizations. Because these entities may have multiple priorities, we recommend designating a lead agency or entity that is asked to prioritize suicide prevention, and can provide administrative support and ensure continuity of effort. Without this designation, partners may be unsure where suicide prevention activities fall, and whether a particular division has the authority to make related decisions or requests.

Identifying and authorizing a lead division or organization that can provide centralized suicide prevention leadership will maximize coordination of efforts among all groups involved in suicide prevention and contribute to a more comprehensive approach. If more than one entity is currently responsible for suicide prevention, it is critical to establish close collaboration and designate one entity as the lead, while maintaining momentum and support in the other entities. This lead entity should be responsible for facilitating coordination with other agencies and organizations.

Recommendations

Designating a government department as a lead entity can have several advantages, including easier access and collaboration within state divisions, and links to those with authority over state contracts. Management by an independent, non-government organization can be useful in facilitating collaboration across government agencies and private sector contributors, and in conducting activities not appropriate for state entities to pursue, such as lobbying.

Suicide prevention efforts must often braid together different funding streams and continuously find new funding sources to support their infrastructure and programs. To address this challenge, states should regularly identify the level of funding needed and secure one or more state-level sources of dedicated funding for suicide prevention.

One way to do so is to ensure that the state budget includes a line item for suicide prevention, including a leadership position and core staffing (see Lead). States should also authorize the pursuit of outside funding, such as funding from non-government agencies, foundations, and others in the private sector. The funding should be sufficient to support all six essential elements of the state infrastructure for suicide prevention.

As originally called for in the National Strategy for Suicide Prevention, each state should maintain a regularly updated and comprehensive plan that guides and coordinates suicide prevention activities, including measurable outcomes. As described in Build, the plan should use a multifaceted, lifespan approach across the state. Development of the plan should be guided by input from a broad range of stakeholders, including partner groups (see Partner).

The plan should help focus and coordinate suicide prevention efforts in the state and guide the implementation of activities in collaboration with national and local partners. To promote continuity the plan should be integrated with the state crisis plan. To ensure that the plan continues to meet the needs of the state’s population and also reflects national priorities, it should be reviewed and revised every three to five years.

To further strengthen your infrastructure

Having specific authority to lead suicide prevention efforts can help the state agency or organization in many ways, such as in easing access to suicide surveillance data, working with other state agencies and partners,¹ raising funds or in-kind resources, and supporting the enactment of policies that can have a greater impact on suicide prevention. Such authorization could be through legislation or an executive order stating that the agency will have access to such services and cooperation from other state government offices so as to enable the agency to carry out its suicide prevention duties, for example.

An annual report is useful in the following ways:

• Providing public transparency on suicide prevention efforts
• Acting as a reminder of suicide prevention to decision-makers
• Helping to maintain momentum among suicide prevention personnel and coalitions by keeping them accountable
• Serving as a useful planning and evaluation tool for those conducting suicide prevention activities
• Providing a foundation for state plan updates

An annual progress and needs report to the legislature or governor serves as an update on the state of suicide and prevention efforts and emerging needs. It should include an analysis on the extent and effectiveness of any statute or rule related to suicide. Even if an annual report is not required, creating one and/or conducting an evaluation of the state plan are important processes to keep efforts on track and maintain accountability.

References

1. Daniel D. Stier, JD, Melisa L. Thombley, JD, MPH, Melvin A. Kohn, MD, MPH, & Rebecca A. Jesada, JD. (2012). The Status of Legal Authority for Injury Prevention Practice in State Health Departments. American Journal of Public Health, 102(6), 1067–1078.