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National Strategy for Suicide Prevention [Internet]. Washington (DC): US Department of Health and Human Services; 2024.
A timeline of national milestones in the field of suicide prevention from 1958 to 2012 is in the 2012 National Strategy for Suicide Prevention, Appendix C.
The National Strategy for Suicide Prevention (National Strategy) was originally released in 2001 by the U.S. Surgeon General and the National Action Alliance for Suicide Prevention (Action Alliance) and was last updated in 2012. In 2021, the U.S. Surgeon General issued a Call to Action to Implement the National Strategy for Suicide Prevention, (Office of the Surgeon General, 2021) asking for a renewed focus on implementation of the 2012 National Strategy.
In 2023, the White House launched an effort to revise and update the 2012 National Strategy. The charge and coordination of the work was entrusted to the Department of Health and Human Services’ (HHS) Suicide Prevention and Crisis Care subcommittee (SPCC) of the Behavioral Health Coordinating Council (BHCC). The SPCC subcommittee was already working to advance implementation of the 2021 Surgeon General’s Call to Action, the 988 Suicide and Crisis Lifeline, and community-based comprehensive and coordinated suicide prevention efforts.
The 2024 National Strategy development was led by a Project Management Team with expert input from the newly formed Interagency Work Group (IWG) comprised of agency suicide prevention leads across HHS and other federal departments, with support from the Suicide Prevention Resource Center (SPRC) and the Action Alliance.
Topics of interest were added to the 2024 National Strategy to showcase alignment with broader national priorities in the suicide prevention field: health equity, youth and social media, substance misuse and suicide, and crisis care.
Since the release of the 2012 National Strategy, progress has been made toward implementing its goals and objectives. Research funding has grown; new grant opportunities were made available for communities and states; and the new National Suicide Prevention Lifeline three-digit number 988 became available. Additionally, policies and laws were signed and implemented to increase access to suicide crisis care, reduce stigma, and prevent suicides in our nation.
These are just some of the highlights, and a more complete listing is available in Appendix F. Among these key developments was the Prioritized Research Agenda for Suicide Prevention: An Action Plan to Save Lives (National Action Alliance for Suicide Prevention, 2014), which evolved from one of the goals in the 2012 National Strategy that emphasized the need to prioritize research to reduce suicide. Additionally, the first portfolio of analyses of U.S. research investments was published in 2015: U.S. National Suicide Prevention Research Efforts: 2008–2013 Portfolio Analyses (National Action Alliance for Suicide Prevention, 2015).
The 2017 National Strategy for Suicide Prevention Implementation Assessment Report noted that there was more suicide prevention activity in the United States than ever before (Substance Abuse and Mental Health Administration [SAMHSA], 2017). This statement was established by comparing the benchmark activities detailed in the 2010 publication Charting the Future of Suicide Prevention: A Progress Review of the National Strategy and Recommendations for the Decade Ahead with the initiatives compiled by a collaborative advisory group.
In 2015, President Obama signed the Clay Hunt Suicide Prevention for American Veterans (SAV) Act, named in memory of Clay Hunt, a military Veteran who lost his life to suicide in 2011. The law is aimed at reducing suicides of active-duty military personnel and Veterans by improving their access to quality mental health care. In 2018, President Trump signed the Executive Order to Improve Access to Mental Health Care for Transitioning Service Members (U.S. Department of Veterans Affairs, n.d.). The order was written to ensure Veterans have access to any needed mental health care for at least one year following discharge from military service. Research showed that in the year following discharge from active duty, the transition from military service to civilian life could pose many challenges that increased the risk of suicide (U.S Department of Veterans Affairs, 2019). In addition, in 2019, President Trump signed Executive Order 13861 to create the National Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS). In 2021, President Biden signed the Brandon Act, named in memory of Petty Officer Third Class Brandon Caserta who died by suicide in 2018. The law required a self-initiated referral process for service members to request a mental health evaluation through a commanding officer or supervisor grade E-6 or above confidentially.
The National Suicide Hotline Improvement Act became law in 2018. This act required the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Veterans Administration to report on the effectiveness of the existing National Suicide Prevention Lifeline (NSPL) and the potential value of a three-digit number as the new national suicide prevention number. The findings were shared with the Federal Communications Commission (FCC), and in July of 2020, the FCC issued a final order designating 988 as the new NSPL and Veterans Crisis Line (VCL) number. That October, the National Suicide Hotline Designation Act of 2020 was signed into law, incorporating 988 into statute as the new NSPL and VCL phone number. In July 2022, the United States transitioned to this easy-to-remember three-digit 988 number, which improved access to immediate support to meet the nation’s growing mental health, suicide, and substance use distress needs. The 988 Suicide and Crisis Lifeline offers 24/7 call, text, and chat access to trained crisis counselors who can help people experiencing suicidal, substance use, and/or mental health crises, as well as any other kind of emotional distress. Based on data provided by 988 call centers, approximately 98% of answered 988 calls do not require an emergency response. Of the 2% of the calls that do require an emergency response, over 60% of those calls are ones where the caller agrees that emergency services are needed and collaborates with the counselor to receive those services (SAMHSA, 2023a).
The Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act of 2021 was unanimously supported by the U.S. House and Senate and was signed by President Biden in 2022. The law is designed to encourage states and tribes to implement and expand evidence-based suicide prevention training in schools.
The National Violent Death Reporting System (NVDRS) is an active surveillance system that collects data regarding violent deaths, including suicide, in the United States. The NVDRS links information from over 600 unique data elements to provide insight about why a death occurred. In 2002, NVDRS began collecting data in six states, and by 2018, the Centers for Disease Control and Prevention (CDC) expanded NVDRS funding to all 50 states, Washington D.C., and Puerto Rico (Liu et al., 2023).
The Mayor’s Challenge was launched in March 2018 with representation from eight cities. The goal of the Mayor’s Challenge was to eliminate suicide among Veterans, service members, and their families by promoting a comprehensive public health approach that empowers communities to act. It expanded into the Governor’s Challenge in 2019, with seven states participating and replicating the community effort at a state level. As of 2023, 54 states and territories are in the Governor’s Challenge, and 19 communities are in the Mayor’s Challenge (SAMHSA, 2023e).
SPRC launched the first-ever State Suicide Prevention Infrastructure Recommendations in 2019. The guidelines lay out essential infrastructure elements for advancing state suicide prevention efforts.
In January 2020, CDC received its first appropriation and launched its flagship Comprehensive Suicide Prevention Program (CSP), funding activities in nine states to implement and evaluate a comprehensive approach with special attention to populations that are disproportionately affected by suicide. To carry out the comprehensive approach, funded recipients 1) convene multi-sectoral partnerships; 2) use data (as available) to identify populations disproportionately impacted and to understand risk and protective factors in those populations; 3) assess current suicide prevention programs in the jurisdiction and where gaps exist; 4) select, implement, and evaluate suicide prevention strategies and approaches with the best available evidence from CDC’s Suicide Prevention Resource for Action; and 5) develop a robust communication plan to keep partners apprised of progress, successes, and lessons learned. By 2023, CDC’s CSP program was funding activities in 23 states and one territory.
In March 2020, COVID-19 was declared a pandemic with a stay-at-home order issued, leading to increases in distress, worsening mental health, and causing nearly a million deaths from the disease across the United States in one year, with some communities hit particularly hard. To address these challenges, funding was made available to provide resources, including, but not limited to, support for virtual suicide prevention programming, a campaign to reinforce the concept “we’re in it together,” and the expansion of tele-mental health.
Public Domain Notice: All material appearing in this publication is in the public domain and may be reproduced or copied without permission from HHS. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the U.S. Department of Health and Human Services Office of the Assistant Secretary for Public Affairs.
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