Module 3  > Data-informed, community-driven interventions​ > Community-level strategies for high-priority populations

In reviewing literature and speaking with communities, one common thread across populations at risk for suicide is that their increased risk is linked to one or more community conditions/THRIVE factors. These factors can intersect to create unique risks for these groups across marginalized identity, age, geography, industry, or stressful life circumstances. Understanding the relationship between THRIVE factors and suicide risk can help you to identify specific risk and protector factors that may be particularly important to address with these populations.

Suicide risk and protective factors with particular impact on high-priority populations

  • Factors in the economic and educational environment: Rural communities, people experiencing homelessness, and people that work in certain high-risk industries all face challenges in the equitable opportunity THRIVE cluster. Living wages and local wealth/assets are particularly important.  Economic stress and economic recession have been linked to increased suicide risk in rural communities, and people who work in industries experiencing decline, such as manufacturing and mining, also experience higher suicide risk. For young people experiencing homelessness, access to tangible assistance such as tents, showers, and fare for public transportation are protective and have been linked to decreased suicide risk. Suicide prevention strategies that strengthen economic supports are particularly important to consider to address suicide risk for these populations.

  • Factors in the physical/built environment: Rural communities, people experiencing homelessness, people that work in certain high risk industries, as well as young people and elderly people face challenges associated with the THRIVE place cluster. What’s sold and how it’s promoted is of particular importance. Increased access to lethal means, particularly access to firearms, is linked with increased suicide risk in each of these populations.  Reduced access to lethal means, especially firearms, is protective for each of these populations. Suicide prevention strategies that create protective environments by reducing access to lethal means are critical to reducing suicide risk across these groups.

  • Factors in the sociocultural environment: Elderly people, young people,  and people experiencing homelessness face challenges with the people THRIVE cluster, particularly in terms of norms and culture in the settings where they interact. Norms, culture, social networks and trust are particularly important.  Unsafe school climate and high levels of victimization at school place young people at heightened risk, particularly LGBTQ+ young people and young people experiencing homelessness. Screening young people for anxiety and ACEs and linking them to appropriate treatment and supports has been found to be protective. For elderly people, gatekeeper training in long term care facilities helped to reduce stigma and isolation. Identifying and supporting people at risk and promoting connectedness are key suicide prevention strategies to consider for supporting these populations.

There is evidence that some of the seven strategies included in the CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices may be particularly beneficial for certain high-risk populations based on the related THRIVE factors. For example, strengthening economic supports by increasing the minimum wage, creating safe environments by reducing access to firearms, and identifying and supporting people at risk through gatekeeper training might be particularly effective for reducing suicide for these populations. 

Reflection Questions

  • What is the relationship between the THRIVE factors and suicide risk for one of the high-risk populations that you identified in your community?

  • What is one additional intervention under each of the suicide-prevention strategies listed above that you might consider to equitably meet the needs of these populations?

Spotlight

The COVID-19 pandemic has altered the landscape for communities across the United States, unleashing unemployment and industry-specific economic recession; increased victimization for Asian-Americans, and disproportionate health impacts for communities of color; and social isolation and changes to longstanding cultural norms and expectations. While U.S. suicides declined overall in 2020, several state and local studies show a rise in suicides among people of color when compared with previous years. As your community responds to the COVID-19 pandemic, consider what strengthening economic security, creating safe environments, and identifying and supporting people at risk looks like in this context. For example, enhanced unemployment benefits for those unable to access federal benefits, expanded telehealth reimbursement, and virtual screening and assessment tools can be part of how your community addresses suicide risk in the context of the pandemic.

Quiz

Click each item in turn to check your answer.

The answer is e, all of the above. Many restaurant workers have lost their job during the pandemic, impacting equitable opportunity; grocery-store workers and nurses have faced changes to the safety of their work environments, and teachers have experienced major changes to norms and cultural practices, whether teaching remotely or on site.

 

A list of references for this section is available here.

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