Suicide prevention has been based on a mental health treatment approach because clinical conditions (e.g., depression, anxiety, psychosis, or alcohol and substance dependence) are apparent among many who kill themselves (3). However, this approach only reaches small segments of the population who have identified risk factors and who can surmount treatment barriers, such as stigma and limited availability of or access to services (4). This orientation is also too limiting because most persons with mental health problems do not engage in suicidal behavior or die by suicide. First-time suicide attempts can be fatal, and suicide warning signs (e.g., depression, increased use of drugs or alcohol, or mood changes) can be common symptoms among nonsuicidal persons and not predictive of future suicide attempts or suicide. Thus, a treatment-only approach to prevention has limited impact on national rates of suicide and nonfatal suicidal risk behavior (5).
David-Ferdon C, Crosby AE, Caine ED, Hindman J, Reed J, Iskander J. CDC Grand Rounds: Preventing Suicide Through a Comprehensive Public Health ApproachExternal. MMWR Morb Mortal Wkly Rep 2016;65:894–897.