Suicide Prevention, Part 2: Evidence-Based Practices, Cost-Effectiveness, and Future Directions

November 2020

Despite clinicians’ best efforts at prevention, suicide rates continue to rise year after year, and many experts fear this trend may be exacerbated by the stressors of the COVID-19 pandemic and resultant economic collapse.

This second installment of a double collection on suicide prevention begins with seminal publications on evidence-based strategies for suicide prevention. Included are post–emergency department (ED) interventions, brief cognitive-behavioral therapy and other therapeutic modalities, and technological innovations to improve information sharing on suicide risk. The next section demonstrates the cost-effectiveness of interventions that can not only save lives but also reduce costs—some interventions are as simple as a postdischarge phone call from the ED. Finally, we present a range of opinion pieces on the future of suicide prevention from leading voices in the field, which, when taken together, make a clear statement: there is much work yet to be done to move the needle on suicide prevention.

Matthew L. Goldman, M.D., M.S.
Lisa B. Dixon, M.D., M.P.H.

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Saving Money While Saving Lives

Screening and Intervention for Suicide Prevention: A Cost-Effectiveness Analysis of the ED-SAFE Interventions
Laura J. Dunlap, Ph.D., Stephen Orme, M.A., Gary A. Zarkin, Ph.D., Sarah A. Arias, Ph.D., Ivan W. Miller, Ph.D., Carlos A. Camargo Jr., M.D., Dr.P.H., Ashley F. Sullivan, M.S., M.P.H., Michael H. Allen, M.D., Amy B. Goldstein, Ph.D., Anne P. Manton, Ph.D., A.P.R.N., Robin Clark, Ph.D., Edwin D. Boudreaux, Ph.D.
2019, Volume 70, Issue 12, pp. 1082–1087


Modeling the Cost-Effectiveness of Interventions to Reduce Suicide Risk Among Hospital Emergency Department Patients
Peter Denchev, Ph.D., Jane L. Pearson, Ph.D., Michael H. Allen, M.D., Cynthia A. Claassen, Ph.D., Glenn W. Currier, M.D., M.P.H., Douglas F. Zatzick, M.D., Michael Schoenbaum, Ph.D.
2018, Volume 69, Issue 1, pp. 23–31


The Return on Investment of Postdischarge Follow-Up Calls for Suicidal Ideation or Deliberate Self-Harm
John S. Richardson, M.P.H., Tami L. Mark, Ph.D., M.B.A., and Richard McKeon, Ph.D., M.P.H.
2014, Volume 65, Issue 8, pp. 1012–1019

Evidence-Based Prevention

An Emergency Department Intervention for Linking Pediatric Suicidal Patients to Follow-Up Mental Health Treatment
Joan Rosenbaum Asarnow, Ph.D., Larry J. Baraff, M.D., Michele Berk, Ph.D., Charles S. Grob, M.D., Mona Devich-Navarro, Ph.D., Robert Suddath, M.D., John C. Piacentini, Ph.D., Mary Jane Rotheram-Borus, Ph.D., Daniel Cohen, M.P.H., and Lingqi Tang, Ph.D.
2011, Volume 62, Issue 11, pp. 1303–1309


An Emergency Department Intervention and Follow-Up to Reduce Suicide Risk in the VA: Acceptability and Effectiveness
Barbara Stanley, Ph.D., Sadia R. Chaudhury, Ph.D., Megan Chesin, Ph.D., Kristin Pontoski, Ph.D., Ashley Mahler Bush, M.M.H., Kerry L. Knox, Ph.D., Gregory K. Brown, Ph.D.
2016, Volume 67, Issue 6, pp. 680–683


Differential Effects of Brief CBT Versus Treatment as Usual on Posttreatment Suicide Attempts Among Groups of Suicidal Patients
Craig J. Bryan, Psy.D., A.B.P.P., Alan L. Peterson, Ph.D., A.B.P.P., M. David Rudd, Ph.D., A.B.P.P.
2018, Volume 69, Issue 6, pp. 703–709


Medical Records Flag for Suicide Risk: Predictors and Subsequent Use of Care Among Veterans With Substance Use Disorders
Joanna M. Berg, Ph.D., Carol A. Malte, M.S.W., Mark A. Reger, Ph.D., Eric J. Hawkins, Ph.D.
2018, Volume 69, Issue 9, pp. 993–1000


A Novel Intervention for Treatment of Suicidal Individuals
Dana Alonzo, Ph.D., and Barbara Stanley, Ph.D.
2013, Volume 64, Issue 5, p. 494

Future Directions

A Strategic Approach for Prioritizing Research and Action to Prevent Suicide
Beverly Pringle, Ph.D., Lisa J. Colpe, Ph.D., M.P.H., Robert K. Heinssen, Ph.D., Michael Schoenbaum, Ph.D., Joel T. Sherrill, Ph.D., Cynthia A. Claassen, Ph.D., and Jane L. Pearson, Ph.D.
2013, Volume 64, Issue 1, pp. 71–75


To Prevent Suicide, Address It Directly
Michael F. Hogan, Ph.D.
2018, Volume 69, Issue 7, p. 737


Promoting Firearm Safety as a Suicide Prevention Strategy Within Health Care Systems: Challenges and Recommendations
Joseph A. Simonetti, M.D., M.P.H., and Lisa A. Brenner, Ph.D.
2020, Volume 71, Issue 3, pp. 298–300


Suicide Prevention in the U.S. Department of Veterans Affairs: Using the Evidence Without Losing the Narrative
Mark B. Warren, M.D., and Leigh A. Smithkors, Ph.D.
2020, Volume 71, Issue 4, pp. 398–400


Critical Foundations for Implementing the VA’s Public Health Approach to Suicide Prevention
Lisa K. Kearney, Ph.D., A.B.P.P., Clifford A. Smith, Ph.D., A.B.P.P., Matthew A. Miller, Ph.D., M.P.H.
2020, Volume 71, Issue 12, pp. 1306–1307


Facilitating Action for Suicide Prevention by Learning Health Care Systems
Rebecca C. Rossom, M.D., M.S., Gregory E. Simon, M.D., M.P.H., Arne Beck, Ph.D., Brian K. Ahmedani, Ph.D., L.M.S.W., Bradley Steinfeld, Ph.D., Michael Trangle, M.D., Leif Solberg, M.D.
2016, Volume 67, Issue 8, pp. 830–832


Integrating Safety Plans for Suicidal Patients Into Patient Portals: Challenges and Opportunities
Virna Little, Psy.D., M.S.W., Jessica Neufeld, M.P.H., Andrea Renee Cole, Ph.D., M.S.W.
2018, Volume 69, Issue 6, pp. 618–619


Preventing Suicide Through Better Firearm Safety Policy in the United States
Jeffrey W. Swanson, Ph.D.
2021, Volume 72, Issue 2, pp. 174–179