State Infrastructure Can Strengthen Suicide Prevention in Health Systems
Public policies help advance evidence-based care practices
State governments that establish suicide prevention infrastructure foster the advancement of sustainable, evidence-based practices within their states’ hospitals and health systems. Recent examples of effective infrastructure include the authorization of comprehensive prevention policies and programs, dedicated funding streams, coordinated leadership, and robust data systems with suicide statistics.
By investing in this kind of infrastructure, states can set clear standards and expectations for suicide prevention, support the long-term sustainability of initiatives and programs, and promote fidelity and accountability within health systems.
Authorizing prevention efforts and sustainable funding
States have used legislation to help drive the adoption of high-quality, evidence-based practices within health systems. For example, Colorado enacted SB 16-147, which created a state prevention plan based on the Zero Suicide model, a comprehensive, systemwide approach used in health care settings to transform how at-risk individuals are identified, engaged, and cared for to reduce suicides and help individuals to receive mental health treatment. This law formally institutionalizes state support for the adoption of Zero Suicide across all health care settings in Colorado.
Sustained progress in suicide prevention initiatives often requires dedicated and continuous funding. States have supported these efforts through annual appropriations as well as through a strategic mix of existing and new state funding, federal grants, and other financing streams. States have also supplemented public funding by pursuing other external investments from foundations, private sector entities, and nongovernment agencies. Colorado, for instance, provides financial incentives for health systems to adopt the Zero Suicide model and has also received federal funding from the Substance Abuse and Mental Health Services Administration to support implementation.
Designating leadership entities and partnerships
States that designate a department, agency, or other entity staffed with full-time prevention experts to lead suicide reduction efforts can bolster the success of these programs. Many states also partner with nongovernment entities, including nonprofit organizations, community-based agencies, and philanthropic foundations to build, finance, and sustain suicide prevention infrastructure. These public-private collaborations may bring together partners from diverse sectors and backgrounds, expanding the capacity and impact of prevention work.
In Illinois, lawmakers passed legislation requiring the state’s Department of Public Health to create a state suicide prevention plan and establish the Illinois Suicide Prevention Alliance to monitor and guide its implementation. This multidisciplinary group of public and private stakeholders includes representatives from mental health organizations, public health officials, and individuals with lived experience, appointed by the director of public health. The alliance facilitates the adoption and implementation of the Zero Suicide model within health care settings, which is one of the key components of the state plan.
In South Carolina, the Department of Behavioral Health and Developmental Disabilities created the Office of Suicide Prevention (OSP) to oversee statewide prevention efforts. OSP collaborates with national, state, and local partners focused on prevention. It also works closely with the South Carolina Suicide Prevention Coalition, a diverse group of state officials and agency leaders, nonprofit organizations, and other community stakeholders charged with implementing prevention efforts, including increasing awareness and understanding of the prevalence of suicide; providing education and resources to health care providers, school systems, and community members; and promoting evidence-based practices such as lethal means safety.
Data collection and evaluation
Research shows that suicide prevention efforts are most effective when they are data-driven, systematically monitored, and continuously evaluated. States can establish data collection and reporting strategies for health systems to track implementation and ensure accountability for hospital-based suicide prevention practices and protocols. This data can guide performance evaluation, inform ongoing improvements, and help to shape future policy and funding decisions.
When Louisiana lawmakers passed its Zero Suicide Initiative, they also directed the Office of Behavioral Health, the agency overseeing implementation, to develop a system for measuring initiative progress. The law also mandated the development of a suicide prevention plan, which outlined strategies for collecting and analyzing data to guide and improve the initiative and other state prevention efforts.
Integrating health system reporting with broader state and local suicide surveillance helps to ensure that hospital-based prevention efforts are leading to positive outcomes, including a decrease in suicide attempts and rehospitalizations. State data on the prevalence of suicidal thoughts, attempts, hospitalizations, and deaths provide critical insight into the effectiveness of prevention efforts and where gaps remain.
In New York state, the Department of Health’s comprehensive dashboard integrates fatality and self-harm data with hospital discharge data, enabling state officials and other stakeholders to track and understand suicide-related trends at the local, regional, and state levels. These critical outcome updates can guide improvements to existing interventions and inform the development of new prevention strategies.
State policymakers are well positioned to advance hospital-based suicide prevention efforts through strong, coordinated infrastructure. They can help to support successful implementation of critical suicide prevention and care services through effective public policy, dedicated funding, strategic leadership, and consistent evaluation.
Stacey Baxter works on Pew’s suicide risk reduction project.
If you or someone you know needs help, please call or text the Suicide & Crisis Lifeline at 988 or visit 988lifeline.org and click on the chat button.
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