Module 4 > Understanding the technical package

The CDC’s suicide prevention technical package presents a core set of strategies to prevent suicide based on the best available research evidence. First released in 2017, it helps communities and states prioritize activities and understand the role of multiple sectors in preventing suicide. 

The technical package organizes effective efforts into seven broad strategies spanning risk prevention, intervention, and postvention. This list of core strategies can be used to assess state and local resource distribution and comprehensiveness of current efforts, and to develop a balanced, multi-pronged plan to prevent suicide. Each strategy features sample programs, policies, and practices, summarized in the table below. Local governments and coalitions can bring this information together with contextual and experiential evidence in their communities, including local data on populations at higher risk of suicide and awareness of a community’s particular needs during a catastrophic event.

 

The CDC also has released technical packages for other forms of violence including child abuse and neglect, intimate partner violence, sexual violence, and youth violence. There is significant overlap in the strategies recommended to prevent suicide and these other forms of violence.

Quiz

Click each item in turn to check your answer.

The correct answer is “c,” best available research evidence. Communities need to incorporate contextual and experiential evidence into strategy development based on their local context and populations.

Spotlight

As the outbreak of COVID-19 progressed, several commentaries and other journal articles began to identify risk and protective factors that may be pronounced during the pandemic and emerging themes for suicide prevention. These themes overlap with the existing evidence base, with particular attention to the following strategies:

  • Strengthening economic supports - With concerns over the economic repercussions of the pandemic, opportunities exist to address financial stress by ensuring individuals can meet their basic needs, increasing financial safety nets, supporting small businesses, offering job search assistance and training, and subsidizing housing costs.

  • Increasing access and delivery of suicide care - COVID-19 has increased the need for telemental health and allowed states and communities to rapidly overcome previous barriers to implementing telehealth. Articles also mention the importance of integrating care into community-based services that residents already access.

  • Promoting connectedness - As communities employ physical distancing and other COVID-19 mitigation strategies, many articles discuss addressing isolation and loneliness for suicide prevention. These specifically focus on increasing social support and a sense of belonging through virtual connections (video conference, phone calls, remote volunteering, postcards, etc.) and mention older adults and rural communities as priority populations. Communities have adapted events that would have occurred in person to take place virtually and through apps and other innovations (e.g. meet-ups, ceremonies, etc.). 

  • Creating protective environments - Many articles discuss the importance of limiting access to lethal means, including firearms, among those at-risk for suicide and mention at-risk healthcare workers as a population of focus. Creating protective environments has been particularly important as several communities have experienced increases in alcohol consumption, firearm purchases, and overall availability of lethal means such as firearms, opioids, and other substances while staying at home.

For a summary of actionable strategies for policymakers, healthcare leadership, public health and communities during the pandemic, read:

  1. Banerjee D, Kosagisharaf JR, Sathyanarayana Rao, TS. 'The dual pandemic' of suicide and COVID-19: A biopsychosocial narrative of risks and prevention. Psychiatry Research Journal. 2020; Nov 18. doi: 10.1016/j.psychres.2020.113577.
     
  2. Czeisler MÉ, Lane RI, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020. MMWR Morbidity and Mortality Weekly. 2020; 69(32): 1049-1057. doi: 10.15585/mmwr.mm6932a1.
     
  3. Fisher JRW, Tran TD, et al. Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey. Medical Journal of Australia. 2020; 213(10): 458-464. doi: 10.5694/mja2.50831.
     
  4. Gratz KL, Tull MT, Richmond JR, et al. Thwarted belongingness and perceived burdensomeness explain the associations of COVID-19 social and economic consequences to suicide risk. Suicide Life Threat Behavior. 2020; 50: 1140-1148. doi: 10.1111/sltb.12654.
     
  5. Gunnel D, Appleby L, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020; 7(6): 468-471. doi: 10.1016/s2215-0366(20)30171-1.
     
  6. Jobes DA, Crumlish JA, Evans AD. The COVID-19 pandemic and treating suicidal risk: The telepsychotherapy use of CAMS. Of Psychotherapy Integration. 2020; 30(2): 226-237. doi: 10.1037/int0000208.
     
  7. Leaune E, Samuel M, Oh H, Poulet E, Brunelin J. Suicidal behaviors and ideation during emerging viral disease outbreaks before the COVID-19 pandemic: A systematic rapid review. Preventive Medicine. 2020; Dec: 106264. doi: 10.1016/j.ypmed.2020.106264.
     
  8. Mannix R, Lee LK, Fleegler EW. Coronavirus Disease 2019 (COVID-19) and Firearms in the United States: Will an Epidemic of Suicide Follow? Annals of Internal Medicine. 2020; 173(3): 228-229. doi: 10.7326/m20-1678.
     
  9. Monteith LL, Holliday R, Brown TL, Brenner LA, Mohatt NV. Preventing Suicide in Rural Communities During the COVID-19 Pandemic. Journal of Rural Health. 2021; 37(1): 179-184. doi: 10.1111/jrh.12448.
     
  10. Reger MA,  Stanley IH, Joiner TE. Suicide Mortality and Coronavirus Disease 2019-A Perfect Storm? JAMA Psychiatry. 2020;  77(11): 1093-1094. doi: 10.1001/jamapsychiatry.2020.1060. 
     
  11. Riblet NB, Stevens SP, Watts BV, Shiner B. A pandemic of Body, Mind, and Spirit: The Burden of "Social Distancing" in Rural Communities During an Era of Heightened Suicide Risk. Journal of Rural Health. 2020; 37(1): 207-210. doi: 10.1111/jrh.12456.
     
  12. Sheffler JL, Joiner TE, Sachs-Ericsson NJ. The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide. Gerontologist. 2020; 61(1): 23-29. doi: 10.1093/geront/gnaa103.
     
  13. Sher, L. An infectious disease pandemic and increased suicide risk. Brazilian Journal of Psychiatry. 2020; 42(3): 239-240. doi: 10.1590/1516-4446-2020-0989.
     
  14. Wand APF, Zhong BL, Chiu HFK, Draper B, De Leo D. COVID-19: the implications for suicide in older adults. International Psychogeriatrics. 2020; 32(10): 1225-1230. doi: 10.1017/s1041610220000770.
     
  15. Wasserman D, Iosue M, Wuestefeld A, Cali V. Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry. 2020; 19(3): 294-306. doi: 10.1002/wps.20801.
     
  16. Zalsman G, Stanley B, et al. Suicide in the Time of COVID-19: Review and Recommendations. Archives of Suicide Research. 2020; 24(4): 477-482. doi: 10.1080/13811118.2020.1830242.
     
  17. Zortea TC, Brenna CT, et al. The Impact of Infectious Disease-Related Public Health Emergencies on Suicide, Suicidal Behavior, and Suicidal Thoughts. Crisis. 2020; Oct 16: 1-14. doi: 10.1027/0227-5910/a000753.

Next lessons in this section

 

Continue to the next lessons of the "Understanding the technical package" section of Module 4 to understand how the technical package fits with other national frameworks:

 

Go to next lesson