Comprehensive Suicide Prevention: Success Stories

2024 story

Arkansas launches Comprehensive Suicide Prevention initiative for at-risk populations

In 2022, 547 people died by suicide in Arkansas, making it the 13th leading cause of death in the state. Rural populations in Arkansas are disproportionately affected by suicide. CDC funding for Comprehensive Suicide Prevention enabled Arkansas to establish the Arkansas Comprehensive Suicide Prevention Program.

With CDC support, the Arkansas Comprehensive Suicide Program hired a dedicated suicide prevention program manager and a communication specialist, who both enhanced programs and forged vital partnerships across the state. Key collaborations were formed with organizations such as Hometown Health Initiative, American Foundation for Suicide Prevention Arkansas Chapter, Arkansas Department of Human Services Office of Substance Abuse and Mental Health, Arkansas Lifeline Call Center, Arkansas Crisis Center, Western Arkansas Counseling and Guidance Center, Arkansas Foundation for Medical Care, and the American Indian Centers of Arkansas.

Under the program manager’s leadership, various initiatives began, including “Question. Persuade. Refer.” training sessions and a social media campaign partnership with the Arkansas Office of Health Communications. The Arkansas Comprehensive Suicide Prevention Program contracted with Hometown Health Initiative to conduct four trainings monthly, plus additional sessions each month through their own team.

In August 2024, the Arkansas Comprehensive Suicide Program initiated suicide prevention program inventory meetings, in which stakeholders and community members can identify gaps in services. A media campaign was launched in October 2024, and upcoming plans include establishing subcontracting agreements for training programs statewide.

The CDC grant empowered Arkansas to develop an effective Comprehensive Suicide Prevention Program that involves the community and focuses on rural populations most affected by suicide.

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Bexar County launches initiative to address youth suicide

In Bexar County, Texas, the 2024 suicide death rate for males ages 15-44 was more than double the overall suicide death rate for the county. Emergency department visits for suicidal ideation and attempts were also concerning, with higher rates for both males and females in this age group, compared to the general population.

The University Health System, the public hospital district for the San Antonio metro area, used the CDC’s Community Suicide Prevention grant to address these suicide-related statistics. Through their Comprehensive Suicide Prevention Blueprint for Adults and Youth (CoSPLAY) program, they set a goal of reducing suicide deaths and attempts by 10% over four years among individuals ages 15-44 in Bexar County. To achieve this goal, University Health formed twelve new partnerships across educational, health care, nonprofit, and public health sectors.

Key partners include Our Lady of the Lake University, offering Mental Health First Aid training; San Antonio Metropolitan Health District, providing access to suicide related data; and University Medicine Associates, which implementing the Zero Suicide program in pediatric and family medicine ambulatory clinics. The Alamo Area Teen Suicide Prevention Coalition is focusing on youth initiatives while collaborating with the San Antonio Council on Alcohol and Drug Awareness to hire a youth coordinator.

CoSPLAY plans to engage local universities serving higher-risk student populations and provide Youth Awareness of Mental Health training in schools. Collaborations with youth organizations like will enhance community health efforts.

University Health departments plan to deliver training in 2025 on intimate partner violence, gun safety, Counseling on Access to Lethal Means, and other harm reduction services. They are also partnering with telemedicine organizations to improve access to mental health services through programs like Texas Child Health Access through Telemedicine, the Child Psychiatry Access Network, and the Perinatal Psychiatry Access Network.

Through these comprehensive strategies and partnerships, CoSPLAY has a solid plan to help prevent suicide deaths and attempts in Bexar County.

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California counties strengthen suicide prevention through first responder and health care provider training

The California Comprehensive Suicide Prevention program team employs a public health approach to suicide prevention, focusing on thirteen mostly rural counties with higher rates of suicide and self-harm emergency department visits than the state average, according to the California Violent Death Reporting System. Using CDC funds, Humbolt and Shasta Counties have conducted several suicide prevention and lethal means safety trainings for healthcare providers, including first responders like emergency medical technicians (EMTs), who often face stress and secondhand trauma. The goal is that these trainings will help prevent suicide amongst themselves and their peers, as well as within the communities they serve.

From September 2022 to August 2023, these counties facilitated the following trainings

• Code-9
• Let's Talk about Firearm Safety
• Question Persuade Refer with a Lethal Means Safety module
• Counseling on Access to Lethal Means
• Suicide 201: Advancing Suicide Prevention & Management for Diverse Clientele.

Over 200 participants successfully completed the trainings, representing various sectors such as medical and behavioral health care providers, law enforcement officers, state park rangers, and community members including first responders’ families, veterans, the community emergency response team, and dispatchers.

Training objectives included enhancing skills in stress management and cultural awareness of firearm safety, while promoting help-seeking behaviors to cope with secondary trauma. Participants received educational materials in English and Spanish that provided local resources for support and safe storage practices for lethal means.

Survey results from Humboldt County indicated that 90% of participants found the trainings effective, with 88% feeling equipped to refer at-risk individuals to services. Additionally, Humboldt County collaborated with county behavioral health to institutionalize the “Suicide 201” training as a mandatory policy for staff. In Shasta County, participants established a peer support group called “TUF” (Talk, Unwind, Focus), which meets regularly.

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Colorado's Mesa County enhances postvention support through innovative partnership with coroner's office

Through CDC Comprehensive Suicide Prevention funding, Colorado is addressing high suicide rates in six counties by implementing comprehensive strategies, including postvention efforts to reduce harm and prevent future risk. Postvention involves responses, resources, and interventions that provide emotional support and guidance to individuals, families, and communities impacted by suicide.

Mesa County—one of the six CDC-funded counties—established a unique partnership with the county coroner's office by placing a loss coordinator within the office. This role connects death investigators with a community specialist in suicide prevention and serves as a contact person for survivors of suicide loss.

Mesa County's CDC-funded staff implemented several postvention-specific activities:

• Established a strong partnership with the local coroner's office
• Provided 271 initial contacts and follow-ups with suicide loss survivors via phone calls, emails, and text messages
• Assembled and distributed 44 postvention care packages to suicide loss survivors containing resources in both English and Spanish (modeled from the Suicide Prevention Coalition of Colorado's iCare Packages)
• Facilitated 15 peer-led support groups for community members impacted by suicide loss or attempts
• Created and distributed flash drives with postvention training and resources to 15 local media outlets and public information officers to promote safe messaging practices following suicide

By positioning a Comprehensive Suicide Prevention-funded staff member within the coroner's office, Mesa County established an efficient case coordination model to provide support and resources to community members impacted by suicide attempts and loss. This collaboration also enabled timely outreach to local media regarding responsible reporting practices, helping to reduce the harmful effects of uninformed coverage. Additionally, Comprehensive Suicide Prevention funded staff extended their support to other local partner organizations, such as workplaces and businesses, helping them develop and improve their internal postvention response. This may include workplace suicide prevention training and comprehensive postvention response plans.

Mesa County plans to continue this partnership model as part of its formal postvention response plan. This ongoing effort will enhance support for loss survivors while assisting local organizations in establishing effective suicide crisis response.

Links

• Mesa County Suicide Prevention
  • Postvention Support Resources
• Example postvention materials in media flash drive toolkit

2024 story

Connecticut launches successful suicide prevention campaign with engaging video series

The Connecticut Comprehensive Suicide Prevention program launched a suicide prevention marketing campaign from December 2023 to May 2024. This initiative produced fifteen engaging videos in both English and Spanish, featuring visuals and messages that address four identified priority populations in the state. The campaign focused on early warning signs, awareness, and connection to state resources, with messages developed with other state agencies to ensure statewide consistency across suicide prevention efforts.

The video campaign used a four-phased approach, with each phase concentrating on a specific topic: Recognizing signs and symptoms, developing coping and problem-solving skills, identifying and supporting people at risk, and promoting available resources. The videos were disseminated across various social media platforms and paid media channels using marketing strategies to reach the appropriate audiences.

Marketing campaign results:

• Total campaign impressions: 10.4+ million
• Facebook/Instagram Stories/Reels:
  • Total reach: 688,000+ unique users
  • Total engagement: 251,000+
  • Link click rate: 1.43 times higher than benchmark
• Google Video (English):
  • Total impressions: 3.29+ million
  • Total engagements: 765,000+
• Google Video (Spanish):
  • Total impressions: 789,000+
  • Total engagements: 99,000+

Throughout the campaign, the Connecticut Comprehensive Suicide Prevention team monitored engagement metrics such as views, comments, and shares to evaluate impact and refine future outreach efforts to continue to raise awareness of suicide prevention resources in Connecticut. The videos are available for viewing at www.preventsuicidect.org.

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Florida launches Veteran Suicide Prevention Training Series to strengthen community support networks

In 2024, the Veteran Suicide Prevention Training Series was launched in six counties through funding from the Florida Comprehensive Suicide Prevention grant. Florida collaborated with several veteran-serving organizations and accredited suicide prevention training providers to create a comprehensive program designed to strengthen suicide prevention gatekeepers within the community and healthcare system. Collaborating with experts like LivingWORKS and the Fire Watch Council Inc. – a veteran-owned nonprofit dedicated to reducing veteran suicide – Florida gained essential resources that enhance the capacity of community members and health care providers in identifying and responding to this vulnerable population.

The Florida Comprehensive Suicide Prevention program implemented the training series using a multifaceted approach that includes:

• Promoting open conversation to reduce shame around the topic of suicide.
• Providing networking opportunities for community, health care, and social service providers.
• Improving communication and interaction among non-veteran individuals and organizations in relation to veterans.
• Enhancing communities' ability to offer tailored, veteran-specific resources.

In 2024, as part of the training series launch and marketing efforts, the Florida Comprehensive Suicide Prevention program built a network of 148 participants, including health care professionals, social services providers, public health workers, first responders, and veterans from all military branches. Of these participants, 84% established partnerships that will continue supporting veteran suicide prevention efforts beyond the training.

Evaluation results for the Veteran Suicide Prevention Training Series showed that participants rated the training an average of 9.92 out of 10. They universally agreed to recommend it to others, recognized suicide as a serious issue for veterans, and committed to reaching out for help if they observe warning signs of suicide in veterans.

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Empowering Georgia's citizens through connection and safe messaging in suicide prevention

Suicide is a leading cause of injury-related deaths in Georgia, with 1,626 lives lost to suicide in 2022. The Georgia Comprehensive Suicide Prevention program focuses on promoting protective factors at individual, relationship, community, and societal levels to reduce suicide risks and build resilience.

The Georgia Comprehensive Suicide Prevention team collaborated with local partners, including county library systems, population-specific community organizations, and government agencies, to deliver presentations that foster connection and raise awareness of suicide risk factors and protective factors. Key partners such as Ser Familia, We Are Casa, Resilient Georgia, and Community Health Solutions leverage their networks to disseminate information through in-person presentations and social media outreach.

The presentations are designed to be informative, interactive, and easily understood. Participants roleplay scenarios that allow them to apply what they've learned in a practical context. Pre- and post-presentation questions assess information retention and skill adoption.

The Georgia Comprehensive Suicide Prevention team uses each presentation to raise awareness about suicide risk and protective factors while sharing valuable resources for prevention and building capacity with communities throughout Georgia.

Presentations are developed based on strategies outlined in CDC's "Suicide Prevention Resource for Action" guide. This framework promotes connection, encourages safe messaging around suicide, and enhances community engagement.

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The Illinois Department of Public Health expands partnership within the Illinois Suicide Prevention Alliance

The Suicide Prevention, Education and Treatment Act (Public Act 095-0109) created the Illinois Suicide Prevention Alliance to unite public and private mental health organizations to reduce suicide rates. The Illinois Suicide Prevention Alliance has a multi-disciplinary membership appointed by the Director of the Illinois Department of Public Health, including hospital systems, non-profit organizations, state agencies, and individuals with lived experience.

Recognizing the need for broader representation, the Illinois Suicide Prevention Alliance wanted to expand membership, particularly to organizations that focus on rural communities, conduct research, provide faith-based support, manage data systems, and support mental and postpartum health. Given Illinois's varied landscape - which includes rural, suburban, and urban communities – it is important that all communities were represented.

To identify higher-risk population and partnership gaps, the injury and violence epidemiologist at the Illinois Department of Public Health analyzed vital records and hospital discharge data. The higher-risk populations in Illinois included:

• Men ages 50 and older in Champaign, DeKalb, Kankakee, Kendall, Macon, Madison, McLean, Peoria, Rock Island, Sangamon, St. Clair, Tazewell, Vermilion and Winnebago Counties.
• Females 10-19 years old.

By addressing these gaps in partnerships and focusing on suicide prevention programming for these populations, the Illinois Suicide Prevention Alliance set a goal of reducing suicide attempts by 10% by 2027.

Additionally, the Illinois Department of Public Health conducted an environmental scan to identify organizations engaged in suicide prevention efforts but not currently involved with the Illinois Suicide Prevention Alliance. With this information, the public health department can create a partnership plan that expands Illinois Suicide Prevention Alliance membership while enhancing access to suicide prevention resources across the state for the identified higher-risk populations.

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Louisiana sets goal to improve statewide comprehensive suicide data

The Louisiana Comprehensive Suicide Prevention team wanted to improve access to suicide data for prevention partners and address the state's high suicide rate, which was the 12th leading cause of death in Louisiana in 2024. Previously, partners faced challenges because data was inaccessible, leading to an overwhelming number of individual data requests to the state's data team. To address this, the Comprehensive Suicide Prevention team conducted a survey with over 75 partners to identify key data needs. They developed a dedicated webpage featuring a statewide fact sheet, heat map of suicide rates, non-fatal data dashboard, and social media toolkit, which garnered over 650 views shortly after launch.

This initiative has strengthened collaboration among partners, who can now better plan prevention efforts. The Comprehensive Suicide Prevention team plans to create a statewide resource hub for centralized access to data and training. Upcoming initiatives include a communications campaign for Suicide Prevention Month and a fatal suicide data dashboard, all aimed at enhancing Louisiana's long-term suicide prevention strategies.

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Maine's tele-behavioral health initiative tackles mental health care access for rural youth

Maine, one of the most rural states in the U.S., faces significant barriers to mental health care access, crucial for suicide prevention. Suicidal ideation among high school students rose from 12.5% in 2009 to 17.8% in 2023, highlighting the urgent need for improved services. Telehealth offers a viable solution, especially in areas with workforce shortages.

With funding from the CDC Comprehensive Suicide Prevention Grant, the Maine Center for Disease Control & Prevention partnered with the Office of Child and Family Services to launch a tele-behavioral health pilot program. This initiative connects students in rural schools to clinicians via telehealth and community health workers, providing behavioral support and resources.

The program engaged three behavioral health agencies across six rural schools during its first program year (September 2022-June 2023), serving 94 students. Initial evaluations indicate that integrating these services into schools reduces travel, costs, and missed appointments while increasing access. Feedback has been overwhelmingly positive, with 100% of parents and staff recommending it.

A school counselor noted, "...one of the greatest things that I noticed was [...] the overall reduction in the need for me (as a school counselor) to be contacting crisis services for students."

This pilot underscores the importance of community health workers in facilitating tele-behavioral health programs and highlights how effective communication among all stakeholders is essential for success. The Maine CDC has shared insights about this initiative with over 350 people and plans to continue promoting this model as an effective strategy for addressing rural youth's unmet mental health needs.

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Massachusetts offers suicide prevention training for parents and caregivers

Data from the 2021 Massachusetts Violent Death Reporting System showed that the suicide rate for 9th-12th graders and for youth ages 15-24 is concerning, which highlighted the need for programs supporting high school students and their parents and caregivers. Using CDC Comprehensive Suicide Prevention funding, Massachusetts implemented the "Question. Persuade. Refer." Program, a community-based approach through gatekeeper training, "Question. Persuade. Refer." teaches individuals to recognize suicide warning signs and how to help those in crisis.

In Massachusetts, CDC facilitated a Spanish-language "Question. Persuade. Refer." session at Lawrence High School, which has a 94% Latino student population. Over 100 community members attended the workshop.

Survey results showed:

• 75% of attendees were parents of Lawrence High School students.
• 91% rated the training as "very good" or "excellent."
• 100% felt more confident in recognizing risk factors and would recommend the training.
• 100% reported increased knowledge about suicide prevention; 82% learned about local and national resources for referrals.

Attendees expressed appreciation with comments like: "Gracias por esta charla es muy educativa" (Thank you for this educational talk) and "Es bueno que hablen de la salud mental" (It's good that they discuss mental health).

The Suicide Prevention Program will continue collaborating with schools to provide educational training and resources aimed at preventing youth suicide.

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Michigan's community-driven approach for adult men

With CDC Comprehensive Suicide Prevention funding, Michigan is addressing suicide among men ages 25 and older. To understand community needs, the Michigan Comprehensive Suicide Prevention team surveyed local health departments about their requirements for a surveillance dashboard that tracks emergency room visits for suicide ideation or attempts.

The survey garnered 31 responses from 21 local health departments, representing nearly half of the state's public health departments. Findings highlighted the need for timely data, education, and technical assistance to improve local suicide prevention efforts. Support includes guidance on data sources, informed decision-making, recognizing suicide as a public health issue, and safe communication about suicide.

The Michigan Comprehensive Suicide Prevention team also launched a workgroup for collaboration and ongoing support among local health departments. The kickoff meeting in January 2024 attracted 62% of state health departments to attend, where they discussed current interventions, identified barriers, and explored ways the Comprehensive Suicide Prevention program could assist them. The Michigan Comprehensive Suicide Prevention program will continue quarterly meetings to provide education and technical assistance, fostering community-driven interventions to prevent adult male suicide attempts or ideations in Michigan.

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Data in action: Nebraska's bold initiative to combat suicide among men

Before 2024, Nebraska's efforts to prevent suicide faced a big challenge: Getting up-to-date information to guide the state's strategies. In the past, planning was done with incomplete information, leading to strategies based on outdated information, which made it hard to create effective prevention programs.

The CDC Comprehensive Suicide Prevention cooperative agreement with University of Nebraska Public Policy Center led to a partnership with the Department of Health and Human Services, Division of Public Health's Injury Prevention Program . This partnership helps connect data to action. Injury Prevention Program experts can now combine suicide-related data from various sources such as hospitals, pharmacies, and trauma systems, integrating suicide-related information from various resources. This provides a clearer picture of how and where suicide deaths and attempts occur. More importantly, it gives the University of Nebraska Public Policy Center and partners like the Nebraska State Suicide Prevention Coalition timely access to data that can drive prevention efforts.

One key finding from this initiative is that men ages 25-64 in Nebraska are at a higher risk for suicide. In March 2024, Nebraska shared this important data with 85 individuals involved in suicide prevention during a statewide suicide prevention summit. One discovery was that people who die by suicide in Nebraska also have prescriptions for pain medications (like opioids), anxiety medications, and antidepressants. This sparked conversations about how to engage new partners in health care and pharmacies.

In September 2024, a follow-up online presentation reached 19 partners to discuss how they can access and use data from the Nebraska Violent Death Reporting System. Additionally, this initiative has made it easier to share valuable suicide-related data via fact sheets, presentations, and dashboards, strengthening suicide prevention efforts across the state.

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Connecting lives: How the Capital Connect Initiative is transforming youth suicide prevention in New York

The New York State Capital Connect Initiative aims to bring effective suicide prevention programs to the capital region by working with local providers and organizations. One important program is the Youth-Nominated Support Teams, which reduced the risk of death by about 85% among 11- to 14-year-olds according to a 2018 secondary analysis of a clinical trial conducted from 2002 to 2005.^[1] Youth-Nominated Support Teams help people ages 12-24 who have recently attempted or thought about suicide connect with trusted adults in their lives. In this program, young people choose three to four trusted adults to support them as they work through their mental health challenges. These adults receive training to understand the young person's needs and treatment.

When a young person leaves the hospital after a suicide attempt, they start working with a Youth-Nominated Support Team therapist, who meets online with their chosen adults once a week for 90 days. The goal is for these adults to provide emotional support, encourage healthy choices, help the youth stick to their treatment plan, and recognize any signs of suicidal thoughts.

Over the first two years of the initiative, the Capital Connect staff worked hard to increase the number of providers and organizations referring young people and their support systems to the Youth-Nominated Support Team program for training. Their partner, Vita Health, has played a key role in preparing these providers and organizations to effectively refer youth.

In Year 1, three local hospitals began referring young people to the program. Since then, as of September 2024, 17 additional providers and organizations have been trained and are now ready to refer more young people to the program. These include mental health facilities, crisis teams, school-based mental health providers, outpatient clinics, care managers, and other school staff.

This expansion led to a big increase in monthly referrals—from about 2.5 per month in Year 1 to around 8.8 per month in Year 2—a growth of 252%. This significant growth shows that access to this effective program is improving in the region and is likely to keep growing. The diverse range of referral sources means that more young people from various areas now have access to the program, allowing for a wider group of participants.

Partners referring youth to the program continue to express their gratitude for having it available in their area. For example, an adult sibling of a youth referred from a participating Capital Connect referral site said, "Before the Youth-Nominated Support Team Program, I struggled to best support my sibling's mental health. Now, thanks to the program, our bond has strengthened, and he is the healthiest mentally that I've seen in a long time. I've gained skills to better assist him, fostering trust in our relationship as he shares more about his mental health struggles. The Youth-Nominated Support Team Program has facilitated our growth together."

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North Carolina's efforts to combat suicide through ASIST training

In 2022, North Carolina's suicide rate was higher than the national average for that year, and North Carolina veterans, males, non-Hispanic Whites, adults ages 45-64, and rural residents were at an increased risk for suicide. To combat this, the NC Comprehensive Suicide Prevention Team offers Applied Suicide Intervention Skills Training (ASIST) statewide. After the training, participants reported feeling better prepared to intervene in crises.

The NC Comprehensive Suicide Prevention Team hosted a two-day ASIST workshop for 40 participants and trained 48 new ASIST trainers. To overcome the cost barrier of ASIST kits—$50 each plus shipping—the team provided more than 30 free kits to each eligible trainer. By expanding ASIST training across the state, North Carolina is advancing toward becoming a suicide-safer state.

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Providing SBIRT-SC training for North Dakota health care settings

In 2022, North Dakota had the fifth-highest suicide rate in the U.S. To help lower these numbers, North Dakota Healthcare, Opportunity, Prevention, and Education in Suicide prevention (ND HOPES) is working to increase the number of health care facilities that offer effective treatment for suicide and substance use issues.

ND HOPES trains providers and clinicians to provide screening, brief interventions, and follow-up with patients regarding both suicide and substance use prevention. Right now, four health care centers are at different stages of adopting a program called Zero Suicide: Coal Country Community Health Center, Sakakawea Medical Center, St. Luke's Medical Center, and CHI St. Alexius – Bismarck. Over 100 people have been trained using an expanded version of Zero Suicide that also includes training on substance use prevention.

The model is known as SBIRT-SC, or Screening, Brief Intervention, and Referral to Treatment for Suicide Care. Our trainings cover all the core components of the Zero Suicide model, with the addition of evidence-based SBIRT-SC content.

Feedback from the training includes:

• 92% said their knowledge of screening tools improved.
• 94% felt they learned more about safety planning.
• 90% reported better understanding of follow-up procedures for suicide risk.
• 83% indicated they would likely conduct screenings and referrals after the training.
• 84% were satisfied with the quality of the training.
• 82% would recommend it to others.

Participants noted that the training was detailed, yet easy to understand. One individual shared, "The training was very informative and relevant to my work. This is a topic nobody likes to talk about, but it is needed."

ND HOPES will keep training clinicians from health care settings interested in CDC's SBIRT-SC program. CDC also recorded the training sessions so health systems can use them as refreshers or for onboarding new staff members.

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Strengthening suicide prevention in Ohio: A collaborative effort using suicide and overdose fatality reviews

On September 30, 2021, Ohio took a big step towards reducing suicide and overdose deaths in Ohio by officially establishing guidelines for suicide and overdose fatality reviews1 (SFRs) in its laws. This legislation ensures that information shared during these reviews is kept confidential, establishes requirements for annual reporting, and provides guidelines for collecting and maintaining data. Each year, local reviews send their findings to the Ohio Department of Health (ODH) to help identify trends and improve prevention efforts.

Ohio allows local governments to decide whether to conduct an SFR. After the laws were passed establishing the SFRs, many communities were unsure about how to get started. Funding from CDC’s Comprehensive Suicide Prevention (CSP) program helped bring together state and local partners to create a clear plan and guidance for implementing SFRs.

The guidance created is flexible, allowing each community, whether urban, rural, resource-rich, or resource-limited, to tailor their SFR committees to fit their unique needs. ODH has also provided online resources, including webinars, to help SFR boards understand their reporting requirements.

SFRs are valuable because they gather important data that can highlight ways to improve services that can prevent suicide. By increasing the number of SFRs and sharing their findings with ODH, Ohio is working to enhance its prevention strategies and save lives. ODH is tracking how many resources are provided to partners and how many annual reports are submitted. They are also offering funding to help high-need counties set up SFR committees and providing technical assistance to counties that need help with SFR implementation. They are working to expand SFR efforts in specific areas, with five of six youth suicide subgrantees taking advantage of this opportunity.

Ohio’s progress so far:

• Over 30 partners collaborated to create the Ohio Suicide Fatality Review Manual, which was launched on November 12, 2024.
• The first-ever Ohio Suicide Fatality Review Best Practices Summit took place on the same day, attracting 174 attendees from various sectors, including health departments and mental health boards. This event provided valuable training and continuing education credits for professionals in the field.
• Initially, only 10 out of 88 counties had operational SFR committees. By the end of the first year, that number grew to 20, and in the second year, 32 reports were submitted, suggesting that the summit and manual are making a difference.

Ohio plans to launch a dedicated resource page on the ODH website for SFRs in 2025. This page will include the SFR manual, helpful documents, recorded summit sessions, and an interactive map showing contact information for active SFRs in each county. ODH will continue to support communities in establishing SFR committees and planning future summits, ensuring that Ohio remains committed to improving suicide prevention efforts.

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Oregon Firearm Safety Coalition collaboratively approaches preventing gun-related suicide deaths

The Oregon Firearm Safety Coalition is a leader in promoting firearm safety and building community relationships in the Pacific Northwest. One of its key initiatives involved partnering with gun owners to teach firearm safety through a modified “Question. Persuade. Refer.” training. Funded by the Oregon Health Authority through a CDC Comprehensive Suicide Prevention grant, two train-the-trainer events equipped certified “Question. Persuade. Refer.” trainers to deliver this curriculum. Instructors facilitated discussions on safe storage and mental health awareness, alleviating concerns among gun owners about potential firearm confiscation.

As a result of these trainings, participants reported improved understanding of secure firearm storage practices and how to distance individuals at risk for suicide from firearms. The Oregon Firearm Safety Coalition’s emphasis on collaboration with public health experts and gun ranges has shifted perceptions and addressed the root causes of firearm-related deaths. The coalition's efforts have contributed to declining rates of firearm-related deaths in Oregon, demonstrating that relationship-building and shared values are essential for preventing loss of life.

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PERU launches suicide prevention training to support veterans in the justice system

In 2023, five Pennsylvania justice institutions launched a comprehensive training initiative to understand the unique challenges faced by justice-involved veterans, which are veterans who have served in the U.S. military and have become involved in the criminal justice system. Justice-involved veterans often encounter complex issues such as post-traumatic stress disorder (PTSD), moral conflict, military sexual trauma, and substance use disorders, which can lead to interactions with the justice system. To bridge the gap between complex post-military service issues and involvement with the justice system, CDC's Comprehensive Suicide Prevention Program funded and facilitated six sessions of "Question. Persuade. Refer." training tailored for justice-involved veterans, focusing on identifying signs of suicidal ideation and facilitating timely intervention. In Pennsylvania, this initiative included three courthouses within Veterans Treatment Courts and two state correctional institutions, specifically targeting their Veteran Service Units.

Over 175 Pennsylvania justice-involved veterans benefited from this initiative, alongside 25 staff members—including judges, prosecutors, and law enforcement—who received training to better support veterans. Additional sessions from the Veteran and Military Culture Academy covered critical topics like military sexual trauma and veteran substance use disorders. The training equipped key justice system staff with a deeper understanding of military culture and veterans' specific issues. Post-training surveys indicated significant improvements in justice system staff's ability to engage in suicide prevention efforts and "ask the question" to determine if someone is thinking about suicide. Of 26 post-training surveys, 97% reported satisfaction with the content and delivery. The average post-test knowledge score was 77%, and 70% scored 80% or higher.

Following these trainings, remaining Veteran Treatment Courts in Pennsylvania have requested additional "Question. Persuade. Refer." training. A Mercer County law enforcement sergeant said, "All Mercer County law enforcement need to receive this training... annually." Another veteran praised the Houtzdale state correctional institute training as "outstanding" and appreciated how trainers incorporated feedback from previous sessions.

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Breaking barriers: Puerto Rico's innovative approach to suicide prevention through real-time data

Since 2013, the Puerto Rico Department of Health's Commission on Suicide Prevention has consistently published monthly suicide reports. These reports have continued thanks to strong partnerships with local data providers. In 2024, with funding from the CDC Comprehensive Suicide Prevention Program grant, the Puerto Rico Department of Health began creating its first system for tracking suicide-related data, using a national program called BioSense.

To improve how Puerto Rico monitors suicide-related information, the Puerto Rico Department of Health partnered with the National Syndromic Surveillance Program and its Epidemiology and Investigation Division. In early 2024, the Puerto Rico Comprehensive Suicide Prevention program grantee and the Puerto Rico Department of Public Health Syndromic Surveillance System formed an agreement that allows access privileges and training on the Electronic Surveillance System for the Early Notification of Community-Based Epidemics. This system helps collect important data about non-fatal suicide attempts from emergency departments across Puerto Rico. Syndromic Surveillance Coordinator Kevin Colón said, "Timeliness is a crucial factor in public health response. Providing the Puerto Rico Comprehensive Suicide Prevention team with syndromic surveillance tools allows for continuous, and automated information sharing for public health decision-making. This helps improve data communication and targeted implementation of suicide prevention efforts in our communities."

Puerto Rico has taken the following steps to develop the system:

1. Update the definition of "suicide attempts."
2. Create a culturally relevant Spanish definition based on CDC's guidelines.
3. Identify Spanish medical terms that need careful translation.
4. Review terminology files.
5. Evaluate ER alerts obtained using Spanish and English definitions.

Two key lessons learned while setting up this system:

1. Using existing surveillance systems in Puerto Rico makes better use of resources and improves efficiency.
2. Strengthening partnerships within the Puerto Rico Department of Health is crucial for making quicker progress, instead of starting from scratch.

In 2025, the Puerto Rico Department of Health aims to have a complete system for sharing reports with key partners, onboarding more facilities onto the surveillance system platform, and training ED personnel to improve electronic reporting and monitoring of fatal and non-fatal suicide-related events in Puerto Rico.

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Uniting for hope: Rhode Island's collaborative approach to suicide prevention

Before receiving funding from the CDC Comprehensive Suicide Prevention program, Rhode Island lacked a coordinated effort to reduce suicides, despite various initiatives. Recognizing this gap, Rhode Island Department of Health and Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals collaborated with local partners to create a comprehensive Suicide Prevention Strategic Plan, finalized in November 2023.

The plan was developed through more than 50 interviews and data analysis from various sources, including the National Syndromic Surveillance Program and the Rhode Island Violent Death Reporting System. In December 2023, the Governor's Council on Behavioral Health established the Suicide Prevention Advisory Committee to oversee these efforts.

Rhode Island Comprehensive Suicide Prevention program funding played a crucial role in setting up this advisory committee. The funding included hiring a contractor for planning and implementation throughout 2024 and provided resources for staff involvement in committee activities.

The first meeting in April 2024 included 57 participants from 39 different groups and organizations working in suicide prevention. Subsequent meetings fostered productive discussions that address community needs and encourage collaboration among members. CDC funding provided Rhode Island Comprehensive Suicide Prevention program staff and their contractor time to consider necessary infrastructure changes in Rhode Island's public health approach to suicide, contributing to the initial success of the Suicide Prevention Advisory Committee.

One advisory committee member said, "Everyone doesn't need the same sort of assistance. We might want to provide an assessment to folks to ask them what they need should they have an experience with loss due to a death by suicide. Maybe survey community members [about] their needs." Out of these conversations, the group is exploring options like community forums organized by the American Foundation for Suicide Prevention to better understand these needs.

As of December 2024, the Suicide Prevention Advisory Committee held four successful meetings, with more than 160 participants representing 133 groups, and more planned each month in 2025. Moving forward, the advisory committee aims to find ways to increase participation from those with lived experience.

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Bridging the gap: Empowering rural mental health providers through innovative telemental health training

Tennessee used Comprehensive Suicide Prevention funds to address mental health provider shortages across the state, especially across 89 rural counties. People living in these rural areas are 1.5 times more likely to die by suicide, compared to those in cities. To help improve access to mental health care, the Tennessee Department of Health partnered with Centerstone of Tennessee to offer free online training for both licensed and pre-licensed mental health professionals on how to effectively use telemental services, or the use of telecommunications or videoconferencing technology to provide mental health services.

Increasing the ability of providers to provide telemental health services increases access to care among rural Tennesseans. By training more providers in telemental health, the Tennessee Department of Health aims to make it easier for people in rural communities to get the help they need before they face a mental health crisis. Each year, Centerstone of Tennessee hosts 15 virtual webinar series with two training sessions each, totaling 30 training sessions that cover important topics such as suicide prevention, working with veterans, how to relate to others, and group therapy via telehealth. Each year, over 500 people participate in these webinars. In 2022, the three most popular trainings were:

1. Addressing burnout and staff resiliency.
2. Recognizing and talking about suicide risk.
3. Suicide prevention: Working with youth and families.

Since launching this program in May 2021, 1,075 behavioral health providers have participated in the training webinars, representing more than half of Tennessee's counties, and 46 out of the 52 counties involved are rural. Surveys taken before and after the trainings show significant improvements in five key areas:

• Participants felt that telemental health services were more effective.
• They reported being better able to adapt their practices for telehealth clients.
• Their knowledge of best practices improved.
• Their ability to deliver evidence-based practices increased.
• They felt better at building rapport with telehealth clients.

Participants also reported improvements in in keeping clients engaged, using assessment tools, discussing suicide risks, setting boundaries, maintaining privacy and ethics, working with children, and preventing burnout.

Based on feedback from participants and annual Tennessee Department of Health assessments, future training topics will include relapse prevention through telehealth, cognitive behavioral therapy for substance use disorders via telehealth, and ethics related to telemental health services.

2024 story

Making history: Vermont's groundbreaking suicide data linkage project reveals critical insights

In Vermont, suicide is the ninth-leading cause of death, especially affecting working-age adults. However, not much was known about what factors contribute to suicide or how people interacted with various services before their deaths. To address this gap, the Vermont suicide data linkage project was launched to gain a better understanding of:

1. Risk factors for suicide.
2. Groups at higher risk for suicide.
3. Patterns in how Vermonters who died by suicide engaged with state and community systems and services prior to death.

Funding from the Comprehensive Suicide Prevention program helped support analysts in completing this project. This included building partnerships, setting project goals, creating agreements for data sharing, linking and analyzing data, developing recommendations with program staff, writing the report, and sharing the findings.

For the first time in Vermont's history, researchers learned about the different interactions people had leading up to their deaths by suicide. CDC and Vermont partners established eight data use agreements to complete this project, with each partner given flexibility in the types of data shared to the Vermont Department of Health. The results were shared with Vermont's Suicide Prevention Data Workgroup and presented to stakeholders involved in Vermont's strategic plan and the state legislature.

Future plans include sharing these findings more widely to raise awareness of the impact of suicide within various agencies, such as health care interactions during hospital meetings.

Before this project, little was known of how individuals who died by suicide interacted with services, so Comprehensive Suicide Prevention program funding helped conduct a data linkage analysis. The results from the project have been presented to Vermont's legislature and have helped inform Vermont's strategic plan. The report also includes specific recommendations for strategies that could help reduce suicide rates in Vermont.

2024 story

Hope in action: Wisconsin's fight against suicide through connection and care

The Wisconsin Comprehensive Suicide Prevention Program has worked and is still working hard to reduce self-harm among young people in the state. Self-harm doesn’t always mean someone wants to die, but it can increase the risk of suicide. That's why the Comprehensive Suicide Prevention program in Wisconsin is focused on helping teens who struggle with self-harm.

National data showed a rise in self-harm among Wisconsin’s adolescents, especially during September 2022 (14% increase month over month) and January 2023 (40% increase month over month).

To address this issue, the Wisconsin Comprehensive Suicide Prevention team created a communication plan that included social media posts, a news release, and a new web page dedicated to self-harm. The goal was to raise awareness about the increases in self-harm during September and January, share warning signs, explain how self-harm relates to suicide, and offer advice on how to help someone who may be struggling.

The news release led to coverage from ten different news outlets, including two major newspapers, the Milwaukee Journal Sentinel and the Green Bay Press Gazette. Together, these papers reached over 64,000 readers. There was also a three-minute feature on WEAU-TV in Eau Claire, WI, weeks later.

Additionally, relationships strengthened with staff from the state Department of Health Services’ Office of Children’s Mental Health and the Division of Care and Treatment Services.

These messages were intended to reach schools and parents; at least one school district shared an email with parents linking back to the press release.

The Comprehensive Suicide Prevention team also developed a new web page focused on adolescent self-harm. It includes detailed information on what self-harm is, its warning signs, and how different people can help those who are struggling.

The Wisconsin Department of Health Services posted about the increase in self-harm among adolescents three times on Facebook after the news release. These posts reached between 6,800 and 8,700 people each time and received the following engagement from viewers:

• 244 engagements
• 61 reactions
• 18 shares

The article that ran in the Milwaukee Journal Sentinel and the Green Bay Press Gazette used language in its headline that did not align with safe reporting practices for suicide prevention and self-harm. Following this, Comprehensive Suicide Prevention program started a conversation with the Wisconsin Department of Health Services communications team about how to educate Wisconsin reporters on best reporting practices related to these sensitive topics.