New Poll Data Shows US Adults Believe Suicide Can be Prevented

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Q&A

The American Foundation for Suicide Prevention (AFSP), the National Action Alliance for Suicide Prevention (Action Alliance), and the Suicide Prevention Resource Center (SPRC) recently partnered with The Harris Poll to conduct a new national public perception survey of more than 2000 US adults to better understand the public’s attitudes and beliefs about mental health and suicide prevention. We sat down with Doreen Marshall, PhD, Vice President of Mission Engagement for the AFSP, to discuss the poll’s findings.

PT: According to the poll, the majority of adults in the US (94%) see suicide as a preventable public health issue and 83% say they would be interested in learning how they might be able to help someone who may be suicidal. Do these numbers surprise you?

Marshall: I am not surprised in that it seems the public is becoming increasingly aware that suicide is, at its core, a health issue and can be prevented. Over the past few years, we have heard more of those in the public eye speak about their mental health struggles, and this has helped to increase dialogue about both suicide prevention and mental health. While I am glad to see that so many are interested in helping others, it does mean that we need to provide individuals the necessary education to be able to help someone who is struggling.

PT: It is really exciting to see an increase in the value placed on mental health and suicide prevention. What do you think has led to this increase? Has the recent release of the 988 Suicide Hotline impacted public perception?

Marshall: The survey findings show that hopeful gains have been made in valuing mental health and suicide prevention. While there are a multitude of factors that could be contributing to the increased value placed on mental health and suicide prevention, it’s been clear that the COVID-19 pandemic has had a significant impact on the population’s mental health. Experiences such as depression, anxiety, and suicidal thoughts remain prevalent. However, protective mental health measures continue to have a positive impact. There is also a readiness to engage and implement effective suicide prevention strategies widely. The silver linings of the pandemic have been increased dialogue around mental health and help seeking and more individuals reaching out for support, all of which could continue to help prevent suicide.

Our survey also supports this. More people understand the importance of mental health and believe that suicide can be prevented, and more than ever, people are recognizing the importance of and need for taking care of their mental health and seeking help. For example, since the start of the pandemic, a large majority (81%) have become more aware of the importance of taking care of their own mental health, which is on the rise since 2020 (73%).

Since the country has just transitioned to 988, it is unclear what impact it has had on public perception. However, our survey explored the public’s awareness of 988 and its understanding about usage, expectations, and barriers to using crisis services. Currently, there is lukewarm familiarity with 988—17% of US adults are somewhat familiar with it, but only 11% are very familiar. But once described, 8 in 10 say they would be somewhat likely and 39% would be very likely to take advantage of it.

Ideally, the shift to 988 will help make the hotline easier to remember and ultimately increase people’s access to help and support. To help build awareness and education around 988, outreach should be done on the national and state levels. Whether you are a nonprofit organization, business owner, state agency or crisis center, everyone has the responsibility to communicate about 988 effectively in order to help save lives.

PT: Lack of knowledge and training, and lack of affordable and accessible care and support are cited as main barriers to suicide prevention. What do you think are the top 3 ways we can overcome these barriers?

Marshall: We have an opportunity to implement actionable steps that mitigate suicide risk. A few actions I believe policymakers, health care leaders, and organizational leaders can take to overcome these barriers include the following:

• Increasing federal and state investments in and implementing policies that expand access to resources and suicide prevention strategies.
• Giving health care professionals the training, evidence-based treatments, resources, and institutional support necessary to identify signs of suicide risk and provide resources to those struggling. In fact, our survey reaffirms this approach, with 78% of respondents saying they believe training and education for professionals, including first responders, health care providers, community leaders, and faith leaders, would be the most helpful for reducing the number of individuals who die by suicide.
• Improving mental health and suicide prevention among marginalized communities by focusing on efforts and interventions that are based on and reflect the needs and beliefs of the demographic groups they are trying to reach.

PT: Only 31% of adults believe physical health and mental health are treated equally in our current health system. Do you believe they are treated equally? If not, what steps do you think we as a country need to take? How can the average mental health clinician help?

Marshall: I think we have made progress in prioritizing mental health as we do physical health, and it is hopeful to see 76% of respondents say their own mental health is equally important to physical health. However, we must continue to set a societal standard of helping mental health and physical health be valued, discussed, and treated equally in health care. We all have mental health just as we do physical health, and there will be times in our lives when our mental health and/or our physical health is not optimal. Just as you would go to the doctor for a physical health concern like a sprain or high blood pressure, consider doing the same for your mental health.

As a country, we must continue to enforce mental health parity at the national and state levels. The Mental Health Parity and Addiction Equity Act of 2008 ensures equal coverage of mental health and addiction. If you have unlimited visits with your heart doctor, the same is supposed to occur for mental health coverage. In the past, mental health conditions were typically covered at far lower levels than policies for physical health conditions.

On an individual level, there a few steps clinicians can take to reduce suicide risk, including:

• Incorporate routine suicide and mental health screening/rating scales into their practice.
• Use the safety planning intervention and lethal means counseling as an ongoing practice with all patients who have any level of suicidal ideation or suicide risk factors.
• Become familiar with counseling on lethal means and practice this with patients during periods of increased suicide risk.
• Increase the frequency of outpatient visits or communication during periods of increased risk.
• Involve the patient’s family in supportive actions to every extent possible with patient permission. For example, including family in helping to make the home environment safe from lethal means.
• Have a referral list ready to go for CBT, DBT or CAMS-specific suicide risk reducing forms of therapy.
• Learn the data related to treatments including medications and suicide prevention, you can read more here.
• Use AFSP resources to help patients and families learn more (eg, After A Suicide Attempt, After Suicide Loss, How to Have a Real Convo).
• Advocate with the leadership of your health care organization to make suicide prevention a priority of the health system.

PT: According to the poll, 57% believe having open dialogue about mental health is “brave.” How can we get the other 43% on board?

Marshall: Individuals are becoming more comfortable talking about their mental health with clinicians and loved ones and being there for others who are struggling. This progress is encouraging and together, we are reducing barriers to talking about mental health and suicide. For example, our survey found:

• 61% of respondents were comfortable talking about mental health, compared to 2020 when it was only 55%.
• 53% of US adults see getting help from a mental health professional as a sign of strength and having open dialogue about mental health is widely seen as “brave” among most adults in the US. (57%).
• More than half of respondents (57%, up from 50% in 2020) reported that they would go to a mental health provider followed by turning to family or friends (52%), or a crisis line (46%).

While a greater number of people want to take action to help, they need more education around how to talk about mental health and suicide. Most US adults today (69%, higher than in 2018) say something would prevent them from talking about suicide with others, in particular not knowing the right words to say (29%) and not feeling like they have enough knowledge (27%).

However, you do not need special training to have an open, authentic conversation about mental health. Often, just talking about it can be the first important step in staying connected for yourself or someone else and helping get support or treatment if needed. Some quick tips for having a conversation include:

• When someone is struggling, focus on listening to what they are experiencing
• Let the other person share at their own pace
• Refrain from judgment or offering advice—just be there for them
• Check back in, and offer to connect them to help if they need it

You can also download AFSP’s #RealConvo guides about how to start these types of conversations, how to reach out for help, if someone tells you they are thinking about suicide, and how to talk to a suicide loss survivor.

PT: About 8 in 10 individuals would be interested in learning how they might be able to play a role in helping someone who may be suicidal. What information or resources can mental health clinicians share to assist these interested individuals in recognizing warning signs?

Marshall: I think it is important to share information that is accurate but also provides hope. We have several resources on our website (afsp.org). We also have chapters in all 50 states that provide both in person and virtual education and awareness events, all of which can help increase one’s knowledge about suicide prevention and how to prevent it.

PT: Finally, is there anything else you think psychiatrists and mental health clinicians should know about this survey?

Marshall: Anyone who would like to learn more about the survey and how to get involved in advocacy efforts can go to suicidepreventionnow.org. We all have a role to play in preventing suicide and protecting our mental health and becoming informed is an important first step.

Dr Marshall is vice president of mission engagement for the AFSP and a licensed psychologist.