National Strategy 

for Suicide 

Prevention 

Compendium 

of Federal Activities 

2009 
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TABLE OF CONTENTS 

Table of Contents 

PREFACE..................................................................................................11

SUICIDE PREVENTION WORKGROUP...................................................13

NSSP Goals and Objectives for Action: Summary List........................17

SECTION 1: AWARENESS...................................................................................... 17

SECTION 2: INTERVENTION.................................................................................. 17

SECTION 3: METHODOLOGY ................................................................................ 17

SECTION 1: AWARENESS.......................................................................19

NSSP 1.1: By 2005, increase the number of States in which public information 

campaigns designed to increase public knowledge of suicide prevention reach at 

least 50 percent of the State's population.................................................................. 19

NSSP 1.2: By 2005, establish regular national congresses on suicide prevention 

designed to foster collaboration with stakeholders on prevention strategies across 

disciplines and with the public. .................................................................................. 19

NSSP 1.3: By 2005, convene national forums to focus on issues likely to strongly 

influence the effectiveness of suicide prevention messages. .................................... 20

NSSP 1.4: By 2005, increase the number of both public and private institutions active 

in suicide prevention that are involved in collaborative, complementary dissemination 

of information on the World Wide Web. ..................................................................... 21

NSSP 2.1: By 2001, expand the Federal Steering Group to appropriate Federal 

agencies to improve Federal coordination on suicide prevention, to help implement 

the National Strategy for Suicide Prevention, and to coordinate future revisions of the 

National Strategy. ...................................................................................................... 22

NSSP 2.2: By 2002, establish a public/private partnership(s) (e.g., a national 

coordinating body) with the purpose of advancing and coordinating the 

implementation of the National Strategy.................................................................... 22

NSSP 2.3: By 2005, increase the number of national professional, voluntary, and 

other groups that integrate suicide prevention activities into their ongoing programs 

and activities.............................................................................................................. 23

NSSP 2.4: By 2005, increase the number of nationally organized faith communities 

adopting institutional policies promoting suicide prevention. ..................................... 24

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NSSP 3.1: By 2005, increase the proportion of the public that views mental and 

physical health as equal and inseparable components of overall health. .................. 25

NSSP 3.2: By 2005, increase the proportion of the public that views mental disorders 

as real illnesses that respond to specific treatments. ................................................ 26

NSSP 3.3: By 2005, increase the proportion of the public that views consumers of 

mental health, substance abuse, and suicide prevention services as pursuing 

fundamental care and treatment for overall health. ................................................... 27

NSSP 3.4: By 2005, increase the proportion of those suicidal persons with underlying 

mental disorders who receive appropriate mental health treatment. ......................... 28

SECTION 2: INTERVENTION ...................................................................31

NSSP 4.1: By 2005, increase the proportion of States with comprehensive suicide 

prevention plans that a) coordinate across government agencies, b) involve the 

private sector, and c) support plan development, implementation, and evaluation in its 

communities. ............................................................................................................. 31

NSSP 4.2: By 2005, increase the proportion of school districts and private school 

associations with evidence-based programs designed to address serious childhood 

and adolescent distress and prevent suicide............................................................. 32

NSSP 4.3: By 2005, increase the proportion of colleges and universities with 

evidence-based programs designed to address serious young adult distress and 

prevent suicide. ......................................................................................................... 32

NSSP 4.4: By 2005, increase the proportion of employers that ensure the availability 

of evidence-based prevention strategies for suicide.................................................. 33

NSSP 4.5: By 2005, increase the proportion of correctional institutions, jails and 

detention centers housing either adult or juvenile offenders, with evidence-based 

suicide prevention programs...................................................................................... 33

NSSP 4.6: By 2005, increase the proportion of State Aging Networks that have 

evidence-based suicide prevention programs designed to identify and refer for 

treatment of elderly people at risk for suicidal behavior............................................. 34

NSSP 4.7: By 2005, increase the proportion of family, youth and community service 

providers and organizations with evidence-based suicide prevention programs. ...... 36

NSSP 4.8:By 2005, develop one or more training and technical resource centers to 

build capacity for States and communities to implement and evaluate suicide 

prevention programs.................................................................................................. 37

NSSP 5.1: By 2005, increase the proportion of primary care clinicians, other health 

care providers, and health and safety officials who routinely assess the presence of 

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lethal means (including firearms, drugs, and poisons) in the home and educate about 

actions to reduce associated risks............................................................................. 37

NSSP 5.2: By 2005, expose a proportion of households to public information 

campaign(s) designed to reduce the accessibility of lethal means, including firearms, 

in the home................................................................................................................ 38

NSSP 5.3: By 2005, develop and implement improved firearm safety design using 

technology where appropriate. .................................................................................. 38

NSSP 5.4: By 2005, develop guidelines for safer dispensing of medications for 

individuals at heightened risk of suicide..................................................................... 38

NSSP 5.5: By 2005, improve automobile design to impede carbon monoxidemediated suicide........................................................................................................ 39

NSSP 5.6: By 2005, institute incentives for the discovery of new technologies to 

prevent suicide. ......................................................................................................... 39

NSSP 6.1: By 2005, define minimum course objectives for providers of nursing care 

in assessment and management of suicide risk, and identification and promotion of 

protective factors. Incorporate this material into curricula for nursing care providers at 

all professional levels. ............................................................................................... 39

NSSP 6.2: By 2005, increase the proportion of physician assistant educational 

programs and medical residency programs that include training in the assessment 

and management of suicide risk and identification and promotion of protective factors.

.................................................................................................................................. 40

NSSP 6.3: By 2005, increase the proportion of clinical social work, counseling, and 

psychology graduate programs that include training in the assessment and 

management of suicide risk, and the identification and promotion of protective factors.

.................................................................................................................................. 40

NSSP 6.4: By 2005, Increase the proportion of clergy who have received training in 

identification of and response to suicide risk and behaviors and the differentiation of 

mental health disorders and faith crises. ................................................................... 41

NSSP 6.5: By 2005, increase the proportion of educational faculty and staff who have 

received training on identifying and responding to children and adolescents at risk for 

suicide. ...................................................................................................................... 41

NSSP 6.6: By 2005, increase the proportion of correctional workers who have 

received training on identifying and responding to persons at risk for suicide. .......... 42

NSSP 6.7: By 2005, increase the proportion of divorce and family law and criminal 

defense attorneys who have received training in identifying and responding to 

persons at risk for suicide.......................................................................................... 42

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NSSP 6.8: By 2005, increase the proportion of counties (or comparable jurisdictions 

such as cities or tribes) in which education programs are available to family members 

and others in close relationships with those at risk for suicide................................... 43

NSSP 6.9: By 2005, increase the number of recertification or licensing programs in 

relevant professions that require or promote competencies in depression assessment 

and management and suicide prevention.................................................................. 43

NSSP 7.1: By 2005, increase the proportion of patients treated for self-destructive 

behavior in hospital emergency departments that pursue the proposed mental health 

follow-up plan. ........................................................................................................... 44

NSSP 7.2: By 2005, develop guidelines for assessment of suicidal risk among 

persons receiving care in primary health care services, emergency departments, and 

specialty mental health and substance abuse treatment centers, implement these 

guidelines in a proportion of these settings................................................................ 45

NSSP 7.3: By 2005, increase the proportion of specialty mental health and substance 

abuse treatment centers that have policies, procedures, and evaluation programs 

designed to assess suicide risk and intervene to reduce suicidal behaviors among 

their patients.............................................................................................................. 46

NSSP 7.4: By 2005, develop guidelines for aftercare treatment programs for 

individuals exhibiting suicidal behavior (including those discharged from inpatient 

facilities). Implement these guidelines in a proportion of these settings. ................... 47

NSSP 7.5: By 2005, increase the proportion of those who provide key services to 

suicide survivors (e.g., emergency medical technicians, firefighters, law enforcement 

officers, funeral directors, and clergy) who have received training that addresses their 

own exposure to suicide and the unique needs of suicide survivors. ........................ 47

NSSP 7.6: By 2005, increase the proportion of patients with mood disorders who 

complete a course of treatment or continue maintenance treatment as recommended.

.................................................................................................................................. 48

NSSP 7.7: By 2005, increase the proportion of hospital emergency departments that 

routinely provide immediate post-trauma psychological support and mental health 

education for all victims of sexual assault and/or physical abuse. ............................. 49

NSSP 7.8: By 2005, develop guidelines for providing education to family members 

and significant others of persons receiving care for the treatment of mental health and 

substance abuse disorders with risk of suicide. Implement the guidelines in facilities 

(including general and mental hospitals, mental health clinics, and substance abuse 

treatment centers). .................................................................................................... 49

NSSP 7.9: By 2005, incorporate screening for depression, substance abuse and 

suicide risk as a minimum standard of care for assessment in primary care settings, 

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hospice, and skilled nursing facilities for all Federally-supported healthcare programs 

(e.g., Medicaid, CHAMPUS/TRICARE, CHIP, Medicare). ......................................... 50

NSSP 7.10: By 2005, include screening for depression, substance abuse and suicide 

risk as measurable performance items in the Health Plan Employer Data and 

Information Set (HEDIS)............................................................................................ 51

NSSP 8.1: By 2005, increase the number of States that require health insurance 

plans to cover mental health and substance abuse services on par with coverage for 

physical health........................................................................................................... 51

NSSP 8.2: By 2005, increase the proportion of counties (or comparable jurisdictions) 

with health and/or social services outreach programs for at-risk populations that 

incorporate mental health services and suicide prevention. ...................................... 52

NSSP 8.3: By 2005, define guidelines for mental health (including substance abuse) 

screening and referral of students in schools and colleges. Implement those 

guidelines in a proportion of school districts and colleges. ........................................ 52

NSSP 8.4: By 2005, develop guidelines for schools on appropriate linkages with 

mental health and substance abuse treatment services and implement those 

guidelines in a proportion of school districts. ............................................................. 52

NSSP 8.5: By 2005, increase the proportion of school districts in which school-based 

clinics incorporate mental health and substance abuse assessment and management 

into their scope of activities........................................................................................ 53

NSSP 8.6: By 2005, for adult and juvenile incarcerated populations, define national 

guidelines for mental health screening, assessment and treatment of suicidal 

individuals. Implement the guidelines in correctional institutions, jails and detention 

centers....................................................................................................................... 53

NSSP 8.7: By 2005, define national guidelines for effective comprehensive support 

programs for suicide survivors. Increase the proportion of counties (or comparable 

jurisdictions); in which the guidelines are implemented. ............................................ 54

NSSP 8.8: By 2005, develop quality care/utilization management guidelines for 

effective response to suicidal risk or behavior and implement these guidelines in 

managed care and health insurance plans................................................................ 54

NSSP 9.1: By 2005, establish an association of public and private organizations for 

the purpose of promoting the accurate and responsible representation of suicidal 

behaviors, mental illness and related issues on television and in movies. ................ 54

NSSP 9.2: By 2005, increase the proportion of television programs and movies that 

observe promoting accurate and responsible depiction of suicidal behavior, mental 

illness and related issues........................................................................................... 55

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NSSP 9.3: By 2005, increase the proportion of news reports on suicide that observe 

consensus reporting recommendations..................................................................... 55

NSSP 9.4: By 2005, increase the number of journalism schools that include in their 

curricula guidance on the portrayal and reporting of mental illness, suicide and 

suicidal behaviors. ..................................................................................................... 56

SECTION 3: METHODOLOGY .................................................................57

NSSP 10.1: By 2002, develop a national suicide research agenda with input from 

survivors, practitioners, researchers, and advocates................................................. 57

NSSP 10.2: By 2005, increase funding (public and private) for suicide prevention 

research, for research on translating scientific knowledge into practice, and for 

training of researchers in Suicidology........................................................................ 57

NSSP 10.3: By 2005, establish and maintain a registry of prevention activities with 

demonstrated effectiveness for suicide or suicidal behaviors.................................... 58

NSSP 10.4: By 2005, perform scientific evaluation studies of new or existing suicide 

prevention interventions............................................................................................. 58

NSSP 11.1: By 2005, develop and refine standardized protocols for death scene 

investigations and implement these protocols in counties (or comparable 

jurisdictions)............................................................................................................... 58

NSSP 11.2: By 2005, increase the proportion of jurisdictions that regularly collect and 

provide information for follow-back studies on suicides............................................. 59

NSSP 11.3: By 2005, increase the proportion of hospitals (including emergency 

departments) that collect uniform and reliable data on suicidal behavior by coding 

external cause of injuries, utilizing the categories included in the International 

Classification of Diseases.......................................................................................... 60

NSSP 11.4: By 2005, implement a national violent death reporting system that 

includes suicides and collects information not currently available from death 

certificates. ................................................................................................................ 60

NSSP 11.5: By 2005, increase the number of States that produce annual reports on 

suicide and suicide attempts, integrating data from multiple State data management 

systems. .................................................................................................................... 60

NSSP 11.6: By 2005, increase the number of nationally representative surveys that 

include questions on suicidal behavior. ..................................................................... 61

NSSP 11.7: By 2005, implement pilot projects in several States that link and analyze 

information related to self-destructive behavior derived from separate data systems, 

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including for example law enforcement, emergency medical services, and hospitals.

.................................................................................................................................. 62
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NSSP Compendium-Final 3-27-09 Page 10 of 62 
PREFACE 

PREFACE 

In 2001, the U.S. Department of Health and Human Services issued the National 

Strategy for Suicide Prevention. The Office of the Surgeon General coordinated the 

efforts of numerous agencies, including SAMHSA, CDC, NIMH, HRSA, IHS, and other 

public and private partners to develop the first, comprehensive, integrated, public health 

approach to reducing deaths by suicide and suicide attempts in the United States. This 

effort was also pursuant to Congressional resolutions -S.Res 84 and H.Res 212 which 

declared that suicide was a national problem, requiring a national strategy to prevent 

suicide. In 2003, the President’s New Freedom Commission on Mental Health reiterated 

the call for full implementation of the National Strategy for Suicide Prevention 

The National Strategy for Suicide Prevention contains 11 goals and 68 objectives. While 

the strength of the National Strategy lies in the comprehensiveness of these 

recommendations, the scope and magnitude of the plan makes assessment of progress 

towards implementing the National Strategy more complex. Some objectives may be 

completely fulfilled, others partially fulfilled, and others not fulfilled at all. In order to 

begin a process of updating the National Strategy, the Federal Working Group on 

Suicide Prevention has requested input from its members on work being done by 

Federal agencies that may be relevant to any of the National Strategy objectives. The 

following document; National Strategy for Suicide Prevention Federal Activities, 

contains the information obtained from this request. It should be noted that this is only a 

partial list of Federal activities relevant to NSSP objectives, as there are Federal 

agencies not participating in the Federal Working Group on Suicide Prevention. This 

also does not include the significant amount of work on National Strategy objectives 

completed by private organizations, information the Federal Working Group on Suicide 

Prevention is hopeful can be obtained by a planned National Action Alliance to Prevent 

Suicide, itself one of the objectives of the National Strategy. 

The Federal Working Group plans to update this document on Federal Activities on a 

twice yearly basis. 
PREFACE 

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SUICIDE PREVENTION WORKGROUP 

NSSP Compendium-Final 3-27-09 Page 13 of 62 

SUICIDE PREVENTION WORKGROUP 

CHAIR Aaron Werbel, Ph.D. 

CDR. MSC. USN 

Behavioral Health Affairs Officer 

Suicide Prevention Program Manager 

Headquarters, U.S. Marine Corps (MRS) 

Personal and Family Readiness Division 

Department of Defense (DoD) 

Aaron.werbel@usmc.mil

VICE-CHAIR Richard McKeon, Ph.D., MPH 

Public Health Advisor, Suicide Prevention 

Substance Abuse and Mental Health Services 

(SAMHSA) 

Division of Prevention, Traumatic Stress, and 

Special Populations 

Prevention Initiatives and Priority Programs Branch 

Richard.mckeon@samhsa.hhs.gov

MEMBERS

Allen, Sarah 

Department of Education (ED) 

Sarah.allen@ed.gov

Arney, Theresa 

Administration on Aging 

Thresa.arney@aoa.hhs.gov

Carr, Dana 

Department of Education (ED) 

Dana.carr@ed.gov

Cooper, Sheila 

Administration on Children and Families (ACF) 

Sheila.cooper@acf.hhs.gov

Crosby, Alex 

Centers for Disease Control (CDC) 

Aec1@cdc.gov
SUICIDE PREVENTION WORKGROUP 

NSSP Compendium-Final 3-27-09 Page 14 of 62 

MEMBERS

Hare, Isadora 

Health Resources and Services Administration (HRSA) 

Ihare@hrsa.gov

Jourdain, Walter 

Administration on Children and Families (ACF) 

Walter.jourdain@acf.hhs.gov

Katz, Ira 

Department of Veterans Affairs (VA) 

Ira.katz@va.gov

Kemp, Janet 

Department of Veterans Affairs (VA) 

Jan.kemp@va.gov

McGee, Leah 

Substance Abuse and Mental Health Services Administration (SAM

Leah.mcgee@samhsa.hhs.gov

Mullican, Charlotte 

Agency for Healthcare Research and Quality (AHRQ) 

Charlotte.mullican@ahrq.hhs.gov

Pearson, Jane 

National Institute of Mental Health (NIMH) 

jpearson@mail.nih.gov

Rapp, Stephanie 

Office of Juvenile Justice and Delinquency Prevention

Department of Justice (DOJ) 

Stephanie.rapp@usdoj.gov

Swann, Leslie 

Administration on Aging 

Leslie.swann@aoa.hhs.gov

Shahrokh Soosan 

Social Security Administration (SSA) 

Soosan.shahrokh@ssa.gov

HSA) 
SUICIDE PREVENTION WORKGROUP 

NSSP Compendium-Final 3-27-09 Page 15 of 62 

MEMBERS

Warner, Cheryl 

Department of Homeland Security (DHS) 

Cheryl.warner@dhs.gov

Weahkee, Rose 

Indian Health Service (IHS) 

Rose.weahkee@ihs.gov

With thanks to Mike Krivka, SAMHSA DTM, for his contributions to this document. 
SUICIDE PREVENTION WORKGROUP 

NSSP Compendium-Final 3-27-09 Page 16 of 62 

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SUICIDE PREVENTION WORKGROUP 

NSSP Compendium-Final 3-27-09 Page 17 of 62 

NSSP Goals and Objectives for Action: Summary List 

SECTION 1: AWARENESS 

1. Promote awareness that suicide is a public health problem that is 

preventable. 

2. Develop broad-based support for suicide prevention 

3. Develop and implement strategies to reduce the stigma associated with being 

a consumer of mental health, substance abuse and suicide prevention 

SECTION 2: INTERVENTION 

4. Develop and implement suicide prevention programs 

5. Promote efforts to reduce access to lethal means and methods of self-harm 

6. Implement training for recognition of at-risk behavior and delivery of effective 

treatment 

7. Develop and promote effective clinical and professional practices 

8. Increase access to and community linkages with mental health and substance 

abuse services 

9. Improve reporting and portrayals of suicidal behavior, mental illness, and 

substance abuse in the entertainment and news media 

SECTION 3: METHODOLOGY 

10. Promote and support research on suicide and suicide prevention 

11. Improve and expand surveillance systems 
SUICIDE PREVENTION WORKGROUP 

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SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 19 of 62 

SECTION 1: AWARENESS 

PROMOTE AWARENESS THAT SUICIDE IS A PUBLIC HEALTH 

PROBLEM THAT IS PREVENTABLE. 

NSSP 1.1: By 2005, increase the number of States in which public 

information campaigns designed to increase public knowledge of suicide 

prevention reach at least 50 percent of the State's population. 

CDC Staff provides technical assistance for safe messaging. 

DoD Each military Service provides public health information on suicide 

prevention program websites. The Defense Centers of Excellence 

manages numerous websites with public education information. Military 

OneSource conducts national marketing campaigns and Webinars for 

military and family members in all states. 

IHS The IHS Community Suicide Prevention Website provides this information 

to the public at the following web address: 

http://www.ihs.gov/NonMedicalPrograms/nspn/. IHS staff also provides 

technical assistance, tribal consultation and public messaging re: suicide 

prevention and awareness. 

NIMH Staff provides technical assistance for research and practice on safe 

public messaging. 

SAMHSA AD Council Campaign -2007 

VA VA develops and disseminates public health messages related to suicide 

prevention, the availability of the Hotline, mental health issues, and the 

availability of effective mental health care through the VA. 

NSSP 1.2: By 2005, establish regular national congresses on suicide 

prevention designed to foster collaboration with stakeholders on prevention 

strategies across disciplines and with the public. 

DoD The DoD Suicide Prevention Risk Reduction Committee (SPARRC), 

composed of representatives from all the military services and chaired by 

a representative of the Defense Centers of Excellence in Psychological 

Health and Traumatic Brain Injury jointly sponsor with VA an annual 

Military Suicide Prevention Conference to foster collaboration amongst 

disciplines and disseminate information on policy and best practices. The 

conference in January 2009 received over 700 attendees. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 20 of 62 

IHS The "Indigenous Suicide Prevention Research & Programs in Canada & 

the U.S.” conference was held in Albuquerque, NM from February 7-9, 

2006. This was a collaborative effort between IHS, NIH, SAMHSA, and 

Health Canada. As part of the Memorandum of Understanding between 

Health Canada and the United States Department of Health and Human 

Services, an Ad Hoc Working Group on Suicide Prevention was 

established and will plan a similar indigenous suicide prevention 

conference in Canada in 2009. IHS hosts an annual national behavioral 

health conference which provides training and collaboration opportunities. 

The 12 IHS Areas also host their own suicide prevention and behavioral 

health conferences. 

NIMH NIMH collaborates with other organizations in providing research updates 

at national meetings, i.e., DoD/VA Suicide Prevention Conference. 

SAMHSA SAMHSA and IHS are collaborating on a Suicide Prevention Summit. IHS 

and SAMHSA provide an annual national behavioral health conference 

which provides training and opportunities for collaboration on suicide 

prevention and intervention with stakeholders. 

VA VA coordinates suicide prevention activities developed and implemented 

by program offices and a VA Steering Committee on Suicide Prevention. 

NSSP 1.3: By 2005, convene national forums to focus on issues likely to 

strongly influence the effectiveness of suicide prevention messages. 

DoD The DoD Suicide Prevention and Risk Reduction Committee (SPARRC), 

composed of representatives from all the military services, hosts with the 

VA the annual Military Suicide Prevention Conference which includes 

sessions focusing on effective suicide prevention messages and 

strategies. 

IHS Through proposed Action Alliance and at Tribal consultation meetings. 

NIMH Through proposed Action Alliance; and presentations and consultation at 

various national meetings. 

VA Through proposed Action Alliance. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 21 of 62 

NSSP 1.4: By 2005, increase the number of both public and private 

institutions active in suicide prevention that are involved in collaborative, 

complementary dissemination of information on the World Wide Web. 

DoD Each military Service sponsors multiple suicide prevention websites that 

disseminate information on suicide prevention policy, education, 

resources, and best practices. The Defense Centers of Excellence in 

Psychological Health and Traumatic Brain Injury hosts a website that 

disseminates information on suicide prevention. 

HRSA The National Adolescent Health Information Center, funded by the 

Maternal and Child Heath Bureau, updated the Fact Sheet on Suicide: 

Adolescents and Young Adults in 2006. The website address is: 

http://nahic.ucsf.edu/. The Stop Bullying Now Campaign—Take a Stand, 

Lend a Hand: This campaign included resources for young people, 

parents, and educators interested in bullying prevention. The campaign 

includes a web-based animated series, Public Service Announcements, 

and a Resource Kit. 

IHS The IHS Community Suicide Prevention website provides American 

Indian/Alaska Native (AI/AN) communities with culturally appropriate 

information about best and promising suicide prevention and early 

intervention programs and training opportunities. Further information and 

resources can be found at the following address: 

http://www.ihs.gov/NonMedicalPrograms/nspn/. In addition, a 

Memorandum of Understanding between Health Canada and the United 

States Department of Health and Human Services was signed to raise the 

health status of First Nations people in Canada and American 

Indians/Alaska Natives in the U.S. As part of this work, the Honoring Life 

Network, which is a project of the National Aboriginal Health Organization, 

developed a website that offers culturally relevant information and 

resources on suicide prevention for Aboriginal people in Canada. Further 

information and resources can be found at the following address: 

http://www.honouringlife.ca. These websites are directly linked to each 

other. 

NIMH Resources from the NIMH website include: suicide facts from CDC, 

recommendations for the media from AFSP, and national reports on 

suicide prevention. Also coordinates with federal agencies to provide 

information to proposed alliance. 

SAMHSA Through proposed alliance. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 22 of 62 

VA VA will develop a Suicide Prevention Web Site to provide information to 

veterans and families about suicide prevention. 

NSSP 2.1: By 2001, expand the Federal Steering Group to appropriate 

Federal agencies to improve Federal coordination on suicide prevention, to 

help implement the National Strategy for Suicide Prevention, and to 

coordinate future revisions of the National Strategy. 

AHRQ Staff participates on the Federal Partners Senior Workgroup. 

CDC Staff participates in steering group and Federal partners. 

DoD Ongoing activity. 

ED Staff participates in steering group and Federal partnerships. 

HRSA Ongoing activity. 

IHS Ongoing activity. 

NIMH Ongoing activity. 

SAMHSA Ongoing activity. 

VA VA works with the Federal Partners Work Group of Suicide Prevention 

and relevant academic partners to promote the ethical and responsible 

reporting of suicide in news reports, and its depiction in entertainment 

media. 

NSSP 2.2: By 2002, establish a public/private partnership(s) (e.g., a 

national coordinating body) with the purpose of advancing and coordinating 

the implementation of the National Strategy. 

CDC Supporting establishment of Action Alliance. 

DoD Supports the creation of a public/Private partnership through the Action 

Alliance. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 23 of 62 

IHS The IHS Suicide Prevention Committee (SPC) was established and tasked 

with identifying and defining the steps needed to significantly reduce and 

prevent suicide and suicide-related behaviors in AI/AN communities. The 

SPC will finalize a five-year Indian Health System Suicide Prevention 

Strategic Plan which mirrors the National Strategy. In addition, the IHS 

Director has established the National Tribal Advisory Committee on 

Behavioral Health which is made up of Tribal Leaders and the Behavioral 

Health Workgroup which consists of clinical leaders. These two groups 

provide recommendations to IHS on funding and behavioral health issues 

such as suicide prevention. 

NIMH Through proposed alliance. 

SAMHSA Through proposed alliance. 

NSSP 2.3: By 2005, increase the number of national professional, 

voluntary, and other groups that integrate suicide prevention activities into 

their ongoing programs and activities. 

AoA Aging Network Organizations involved in suicide prevention activities: 

• NORCs – Naturally Occurring Retirement Communities. 

• Jewish Family Services of San Diego: Creating Opportunities for 

Older Persons (CO-OP). 

• National Alzheimer’s Association – concerns include Caregiver 

Depression. 

• Benjamin Rose Institute – The Care Consultation Project. Target 

population includes elderly participants with diagnosed depression 

DoD Work with local school jurisdictions to educate staff on unique risk factors 

for the public school children of deploying military members. DoD is 

actively working to increase suicide prevention focus on National Guard 

and Reserve component units often in decentralized rural locations. 

Educational campaigns by Tricare Management Activity to increase 

awareness and readiness of local professionals and providers who may 

treat military service members in local communities. 

HRSA The Office of Rural Health Policy (ORHP) is charged with promoting better 

health service in rural America. OHRP funds the Rural Assistance Center 

(RAC), which has produced a resource guide on suicide prevention; 

answers frequently asked questions, as well as provide a glossary of 

terms and acronyms. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 24 of 62 

IHS Staff is assisting American Indian and Alaska Native (AI/AN) communities 

with obtaining culturally appropriate information and training on best and 

promising practices in suicide prevention and intervention. IHS is also 

assisting AI/AN communities with tailoring these practices or programs to 

address their needs. IHS is encouraging IHS, Tribal and Urban programs, 

at the local, Area, and national levels, to integrate suicide prevention 

activities into their ongoing health and mental health delivery programs 

and activities. IHS is promoting an ongoing integration initiative to 

integrate behavioral health with chronic health and health promotion and 

disease prevention. 

NIMH Staff reviewed American Psychiatric Association guidelines; participated in 

CDC efforts to develop common definitions of suicidal behavior; 

participated in SAMHSA meeting on best practices in Emergency 

Departments. 

SAMHSA Through proposed alliance. 

VA VA has strong liaisons between its Chaplaincy and Mental Health 

programs to provide education and training to develop model programs to 

enhance the roles of Chaplains, and through them, community clergy, in 

suicide prevention and promotion of mental health for veterans 

NSSP 2.4: By 2005, increase the number of nationally organized faith 

communities adopting institutional policies promoting suicide prevention. 

CDC Organization website promotes integrated approach to self directed 

violence prevention. 

DoD In all the military services, military chaplains play an active and integral 

role in military suicide prevention efforts. For example, by virtue of their 

position as members of the units they serve, Navy Chaplains play a critical 

role in suicide prevention. Strategies employed by chaplains include 

“deckplate” visitation (i.e., interacting with command personnel in their 

work spaces); individual counseling; pre- and post-deployment briefings; 

briefings to new personnel during command indoctrination; and providing 

training on suicide awareness and prevention. 

Chaplains are key members of the DoD Suicide Prevention and Risk 

Reduction Committee (SPARRC), and participate in the annual DoD/VA 

Military Suicide Prevention Conference in large numbers. Apart from their 

DoD role, chaplains may also leverage their non-military status as clergy 

to influence and train their own national faith groups. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 25 of 62 

IHS The IHS Director's Traditional Medicine Initiative emphasizes the alliance 

of traditional and western medical practices between community traditional 

healers and IHS health care providers across areas of health, including 

suicide prevention and intervention. Through this initiative, the agency 

seeks to foster formal relationships between local service units and 

traditional healers so that cultural values, beliefs, and traditional healing 

practices are respected and affirmed by the IHS as an integral component 

of the healing process (including health/mental health issues revolving 

around suicide). 

NIMH Supports research testing efforts to safely and effectively include faithbased communities in suicide prevention. 

SAMHSA Through proposed Action Alliance. 

VA VA has strong liaisons between its Chaplaincy and Mental Health 

programs to provide education and training and develop model programs 

to enhance the roles of Chaplains, and through tem, community clergy, in 

suicide prevention and the promotion of mental health for veterans. 

NSSP 3.1: By 2005, increase the proportion of the public that views mental 

and physical health as equal and inseparable components of overall health. 

CDC Organization website promotes integrated approach to self directed 

violence prevention. 

DoD The Chairman of the Joint Chiefs of Staff and the Secretary of Defense, 

along with numerous other DoD leaders recently emphasized the 

importance of identifying and treating mental health and suicidal risk with 

the same attention and imperative that is given to physical health 

concerns. The military educates 100% of its personnel on suicide 

prevention every year. This education focuses on understanding mental 

health and mental illness, the risk factors for suicides, appropriate 

interventions for personnel identified as at risk, the benefits of treatment 

for mental health issues, and the reduction of the stigma associated with 

seeking mental health care. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 26 of 62 

HRSA Mental Health and Substance Abuse Expansion Grants seek to expand 

the capacity of Community Health Centers to provide high quality mental 

health/substance abuse care. These grants fund the establishment of 

new or the expansion of existing mental health/substance abuse treatment 

services in Community Health Centers. The Health Disparities 

Depression Collaborative works to ensure that Community Health Centers 

implement and maintain a population-based care model to improve 

depression assessments and care, as well as demonstrate improved 

health care outcomes. 

IHS The IHS Director’s Three Initiatives will raise the wellness and strength of 

the AI/AN people to the highest level through health promotion, behavioral 

health, and a focus on prevention and improving chronic conditions. This 

approach creates and supports a flexible health system that is individual, 

family, and community centered. This includes changing the paradigm of 

mental health services from being specialty and disease focused to being 

a part of primary care and the “Medical Home”. 

NIMH Staff provides technical assistance on federal and private fact sheets on 

mental health and its association with physical health. 

VA VA develops and disseminates public health messages related to suicide 

prevention, the availability of the Hotline, mental health issues, and the 

availability of effective mental care through VA. Messages reducing the 

stigma associated with mental health conditions and help-seeking are 

incorporated into all of VA’s mental health-related public health messages 

and outreach activities. 

NSSP 3.2: By 2005, increase the proportion of the public that views mental 

disorders as real illnesses that respond to specific treatments. 

DoD The Chairman of the Joint Chiefs of Staff and the Secretary of Defense, 

along with numerous other DoD leaders recently emphasized the 

importance of identifying and treating mental health and suicidal risk with 

the same attention and imperative that is given to physical health 

concerns. Combat Operational Stress Control education and awareness 

programs educate military and family members on PTSD and associated 

mental illnesses. The Defense Centers of Excellence on Psychological 

Health and Traumatic Brain Injury provides education to DoD beneficiaries 

and the public on the very real sequelae faced by those suffering from 

mental illness. 
SECTION 1: AWARENESS 

NSSP Compendium-Final 3-27-09 Page 27 of 62 

IHS IHS staff provides public messaging, fact sheets, and technical 

assistance. Education on mental health and mental illness is provided at 

IHS national and regional health and behavioral health conferences and 

summits annually. 

NIMH Staff provides technical assistance on Federal and private fact sheets on 

mental health and its association with physical health; supports research 

on mental health literacy. 

VA As part of its ongoing education and outreach activities, as well as a 

component of care for veterans, VA has developed and disseminates 

psychoeducational materials about suicide prevention for veterans and 

their families. Working through the Suicide Prevention Coordinators in 

each medical center, VA provides “guide” training on warning signs of 

suicide and the availability of effective treatment for individuals in the 

community including veterans, families, and staff from relevant agencies 

and organizations. 

NSSP 3.3: By 2005, increase the proportion of the public that views 

consumers of mental health, substance abuse, and suicide prevention 

services as pursuing fundamental care and treatment for overall health. 

DoD The Department of Defense engages in public education campaigns 

through websites, public service announcements on radio and television, 

newspaper advertisements, and through both required and optional 

annual training in suicide prevention, substance abuse and mental health 

initiatives, in order to educate family members and service members about 

the importance of seeking mental health care for distress and equating it 

with basic health care. Combat Operational Stress Programs are 

emphasizing Psychological First Aid as a corollary to first aid “as usual” to 

demonstrate the equal fundamental nature of mental health. 

IHS IHS staff provides public messaging, fact sheets, and technical 

assistance. Education on mental health and mental illness is provided at 

IHS national and regional health and behavioral health conferences and 

summits annually. 

NIMH Staff provides technical assistance on Federal and private fact sheets on 

mental health and its association with physical health; supports research 

on mental health literacy. 

SAMHSA Through the Garrett Lee Smith Youth Suicide Prevention grant programs 

supports awareness campaigns on youth suicide prevention in states, 

tribes, and colleges. 
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NSSP Compendium-Final 3-27-09 Page 28 of 62 

VA VA’s suicide prevention program is based on the general principles that 

effective suicide prevention requires both public health and clinical 

programs, and that the clinical activities must include ready access to high 

quality mental health services as well as programs directed specifically 

toward suicide prevention. VA promotes access and engagement in 

mental health services through the integration of mental health into 

primary care. 

NSSP 3.4: By 2005, increase the proportion of those suicidal persons with 

underlying mental disorders who receive appropriate mental health 

treatment.

DoD The Services engage in public education campaigns and leadership 

training to encourage service members in distress to seek health care 

from mental health providers. In addition, the Services train their medical 

providers and counseling staff on the proper suicide risk assessment and 

treatment. For example, the Marine Corps trained their Marine and Family 

Services counselors using the SPRC/AAS developed Assessing and 

Managing Suicide Risk curriculum and the Air Force developed the Air 

Force Guide for Managing Suicidal Behavior and the Clinical Management 

of Suicidal Behavior Policy. 

HRSA Mental Health and Substance Abuse Expansion Grants seek to expand 

the capacity of Community Health Centers to provide high quality mental 

health/substance abuse care. These grants fund the establishment of 

new or the expansion of existing mental health/substance abuse treatment 

services in Community Health Centers. The Health Disparities 

Depression Collaborative works to ensure that Community Health Centers 

implement and maintain a population-based care model to improve 

depression assessments and care, as well as demonstrate improved 

health care outcomes. 
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NSSP Compendium-Final 3-27-09 Page 29 of 62 

IHS IHS GPRA measures now include screening for depression in primary 

care settings as best practice in order to assist in identifying patients at 

risk for developing suicidal ideation. Tools have been selected to assess 

depression, monitor response, track such response over time, and are 

incorporated into the IHS Electronic Health Record. IHS has consistently 

met or exceeded target goals for this GPRA depression screening 

measure. Through our Chronic Disease Collaborative and Innovations in 

Primary Care project, there are efforts to integrate behavioral health 

providers directly into primary care settings. Tele-behavioral health 

technology is increasingly adopted to improve access to behavioral health 

services. Currently, over 30 IHS and Tribal facilities in 8 IHS Areas are 

augmenting on-site behavioral health services with tele-behavioral health 

services. This type of system capacity building supports not only distance 

psychiatric services to remote communities where such services are not 

available now but can also be used to share resources more efficiently in 

urban and semi-urban areas. 

NIMH Supports research addressing the issue; recently issued request for 

applications on suicide prevention in emergency departments. SAMHSA 

to collaborate through the provision of education and training on best 

practices. 

SAMHSA Possible NIMH collaboration on topic. 

VA Since 2005, VA has enhanced its mental health services by adding 

approximately 4000 full-time staff, and expanding the range of services 

that are available in VA Medical Centers and Clinics. It has also expanded 

the activities of the Vet Centers in its Readjustment Counseling Service to 

provide outreach to returning veterans and to communities, as well as 

direct counseling.
SECTION 1: AWARENESS 

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SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 31 of 62 

SECTION 2: INTERVENTION 

DEVELOP AND IMPLEMENT COMMUNITY-BASED SUICIDE 

PREVENTION PROGRAMS. 

NSSP 4.1: By 2005, increase the proportion of States with comprehensive 

suicide prevention plans that a) coordinate across government agencies, b) 

involve the private sector, and c) support plan development, 

implementation, and evaluation in its communities. 

DoD Work with local and state suicide prevention offices to provide seamless 

care to at risk service members and their families. Collaborate through 

State National Guard offices to support suicide prevention planning for 

local communities. 

HRSA The Maternal and Child Health Title V Block Grant Performance Measure 

16: the rate (per 100, 000) of suicide deaths among youths aged 15-19. 

State Agency Partnerships to Improve Mental Health for Children and 

Adolescents funded by the Maternal and Child Health Bureau. The goals 

of the partnership included identifying the best practices for suicide 

prevention to school-aged youth and to increase ability of gatekeepers 

who can identify signs of mental health issues and suicidal warning signs. 

IHS IHS coordinates the 5 Areas with high rates of suicides to develop Areawide suicide prevention plans, in alignment with the National Strategy and 

their respective State suicide prevention plans. These areas are also 

developing suicide prevention task forces to reduce suicide activity. As a 

result of the Transformation of Mental Health Care and the National 

Strategy for Suicide Prevention, IHS has formed an alliance with 

SAMHSA, other HHS agencies, and non-governmental organizations, 

States and tribes to address and reduce suicide activity across the U.S. 

and in Indian Country.

NIMH Staff provides technical assistance to States; supports research on 

implementation. 

SAMHSA Progress through Suicide Prevention Resource Center (SPRC) and 

Garrett Lee Smith (GLS) grants. 

VA VA has appointed suicide prevention coordinators, and is developing 

suicide prevention teams in each medical center. Their roles include 

collaborations and coordination of activities with those in each State and 

community. 
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NSSP Compendium-Final 3-27-09 Page 32 of 62 

NSSP 4.2: By 2005, increase the proportion of school districts and private 

school associations with evidence-based programs designed to address 

serious childhood and adolescent distress and prevent suicide. 

CDC Staff provides technical assistance when requested & supports research. 

DoD The Signs of Suicide Prevention Program was modified to meet the 

specific needs of military children and is being offered to middle and high 

schools located on military installations in the U.S. and overseas 

throughout DoDEA. 

ED Grants to local and state educational agencies and Indian Tribes to 

establish linkages between schools and mental health systems, to build 

capacity and expand services; grants to provide qualified mental health 

professionals to schools, staff providers technical assistance as 

requested. 

HRSA Funded two National School Based Mental Health Centers (University of 

Maryland and UCLA). 

IHS In some Areas, IHS staff is collaborating with the schools to provide 

suicide depression screening and other school based health/mental health 

services, suicide prevention education and crisis plans. 

NIMH Staff provides technical assistance as requested; agency supports 

relevant research. 

SAMHSA Garrett Lee Smith (GLS) grants. 

NSSP 4.3: By 2005, increase the proportion of colleges and universities 

with evidence-based programs designed to address serious young adult 

distress and prevent suicide. 

CDC Staff provides technical assistance when requested & supports research. 

ED Grants to institutions of higher education for prevention and intervention 

activities to reduce alcohol abuse; staff provides technical assistance as 

requested. 

IHS Staff is collaborating with some Tribal colleges in the area of suicide 

prevention/intervention (i.e. provide training and education in evidence 

based suicide prevention/intervention skills). IHS sponsors the American 

Indians into Psychology Program - which addresses the issue of suicide. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 33 of 62 

NIMH Staff provides technical assistance as requested; agency supports 

relevant research; current solicitation on college mental health research 

through ARRA funds. 

SAMHSA Garrett Lee Smith (GLS) Grants. 

NSSP 4.4: By 2005, increase the proportion of employers that ensure the 

availability of evidence-based prevention strategies for suicide. 

IHS Staff is assisting American Indian and Alaska Native communities with 

obtaining culturally appropriate information and training on best and 

promising practices in suicide prevention and intervention. Assist 

American Indian/Alaska Native communities with tailoring these practices 

or programs to address their needs. 

NIMH Staff provides technical assistance as requested; agency supports 

relevant research. 

VA VA promotes and supports research on veteran suicide prevention and 

suicide prevention through the Office of Research and Development, the 

Mental Illness Research Education and Clinical Center in Denver, the 

Center of Excellence in Canandaigua, NY, the Serious Mental Illness 

Research Education and Clinical Center in Ann Arbor, the Office of Public 

Health, and other VA entities. 

NSSP 4.5: By 2005, increase the proportion of correctional institutions, jails 

and detention centers housing either adult or juvenile offenders, with 

evidence-based suicide prevention programs.

CDC Staff provides technical assistance when requested. 

IHS In some Areas, IHS, BIA, and tribal law enforcement are collaborating to 

implement evidence based suicide prevention/intervention practices in BIA 

funded and tribal correctional facilities. 

NIMH Agency currently supports SBIR grants on this. 

VA VA provides re-entry services for veterans being released from Federal 

and State prisons. 
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NSSP Compendium-Final 3-27-09 Page 34 of 62 

NSSP 4.6: By 2005, increase the proportion of State Aging Networks that 

have evidence-based suicide prevention programs designed to identify and 

refer for treatment of elderly people at risk for suicidal behavior. 

AoA The programs presented below represent initiatives that have received 

direct funding, support and partnership via the Administration on Aging 

(AoA). The National Council on Aging and the Aging Network partner, 

Sheltering Arms Senior Services, administer Healthy IDEAS (Identifying 

Depression, Empowering Activities for Seniors) Evidence-Based 

Depression Care Management, a national model program funded by the 

Administration on Aging. The project uses evidence-based intervention to 

screen, address and prevent depression in older adults. The Healthy 

IDEAS initiative was initiated in 2003 and to date includes communitybased projects in nine states, seven of which are part of the Aging 

Network directly funded by the US Administration on Aging’s discretionary 

grants program: Maryland (1 site), New Jersey (2 sites), Texas (3 sites), 

and Ohio (1 site). Six Healthy IDEAS sites in Maine are directly funded by 

the State Unit on Aging, local Area Agencies on Aging (AAAs), and 

National Family Caregiver Older American’s Act funding. Two sites in 

Maryland and Vermont are creatively using Older American’s Act Title III 

monies to fund depression intervention and prevention activities. 

 

• Evidence-based Depression Care Management: Program to 

Encourage Active, Rewarding Lives for Seniors (PEARLs) – Based in 

Washington State at the University of Washington’s Health Promotion 

Research Center and supported by multiple private, state and local 

partners. Although no longer currently funded directly via AoA, 

several Aging Network entities are involved in this program, which is 

continuing to broadly disseminate its findings, toolkit and trainings to 

other aging service providers within the Aging Network. Currently, 

two of four sites funded are being implemented in Washington State 

via the Aging Network. 

• AoA’s Alzheimer’s Disease Demonstration Grants to States 

(Caregiver Depression) recipients: 

• Minnesota Board on Aging, Georgia’s Department of Human 

Resources, Division of Aging Services, California Department on 

Aging, Maine Department of Health and Human Services (Healthy 

IDEAS), North Carolina Department of Health and Human Services 

• State Plans on Aging, beginning 2008/2009, that address: Elderly 

Mental Health, Depression and Suicide Issues 

Delaware

o Formalize partnerships and service coordination protocols with mental 

health agencies 
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NSSP Compendium-Final 3-27-09 Page 35 of 62 

o Cross training with aging and mental health staff to identify mental health 

issues 

o Outreach through information, referral and assistance 

Florida

o Train aging staff to identify warning signs for depression and other mental 

health symptoms 

o Create community awareness and education on depression. Provide 

depression prevention tools, e.g. screening, assessment and case 

management protocols. 

Idaho

o Coordinate service provision with mental health agencies 

o Create screening tools for partnering agencies 

Kentucky

o Implement Program to Encourage Active, Rewarding Lives for Seniors 

(PEARLs) project, an evidenced-based depression and mental health 

intervention program 

Louisiana

o Coordinate service with mental health agencies 

o Provide education and awareness about depression symptoms 

Maryland

o Improve service coordination and bridge service gaps by partnering with 

mental health agencies 

Maine

o Coordinate service provision with mental health agencies 

o Provide culturally appropriate sensitivity training to assist staff with 

interacting and addressing the needs of mentally ill clients 

Nevada

o Coordinate service provision with the state Office of Suicide Prevention 

Consumer Education 

o Goals: Reduce incidence of suicide (highest elderly suicide rate in the 

country for the last 20 yrs.), Strengthen partnerships with mental health 

agencies and service providers, Encourage more collaboration with 

mental health agencies and service providers, Train staff in suicide 

prevention techniques, and Advocate for an increase in resources on 

suicide prevention 

Pennsylvania

o Increase awareness of the problem of suicide and prevention strategies: 
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NSSP Compendium-Final 3-27-09 Page 36 of 62 

o Create and introduce suicide risk scales and depression assessment tools 

o Create outreach and prevention strategies 

o Train staff to address the needs of and to identify consumers at risk for 

suicide 

o Encourage more partnerships with mental health providers 

South Carolina

o Improve aging network staff’s identification of clients at risk for depression, 

including caregivers 

o Coordinate service provision with mental health agencies 

 

CDC Staff provides technical assistance when requested. 

IHS IHS staff provides training, technical assistance/consultation to IHS and 

Tribal providers and caregivers of elders. 

NIMH Staff provides technical assistance as requested; agency supports 

relevant research. 

VA VA provides mental health services to older veterans in programs that 

integrate mental health with primary care, home-based care, and longterm care as well as in specialty mental health care programs. 

NSSP 4.7: By 2005, increase the proportion of family, youth and 

community service providers and organizations with evidence-based 

suicide prevention programs. 

CDC Staff provides technical assistance when requested. 

DoD The DoD overall approach to community suicide prevention is based on 

the best current research data and is recognized by SAMHSA’s National 

Registry of Evidence-Based Practices and Programs. 

IHS The IHS Community Suicide Prevention Website provides this information 

to the public. IHS staff also provides technical assistance, tribal 

consultation and public messaging re: suicide prevention and awareness. 

NIMH Staff provides technical assistance as requested, agency supports 

relevant research. Initiative for suicide prevention research in emergency 

departments intended to provide evidence base. 

VA VA provides services to veterans’ families as a component of care 

provided to eligible veterans. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 37 of 62 

NSSP 4.8:By 2005, develop one or more training and technical resource 

centers to build capacity for States and communities to implement and 

evaluate suicide prevention programs. 

DoD DoD created the Defense Centers of Excellence in Psychological Health 

and Traumatic Brain Injury which chairs the DoD Suicide Prevention and 

Risk Reduction Committee (SPARRC) and co-hosts the annual Military 

Suicide Prevention Conference with the VA. SPARRC serves as a 

collaborative effort to ensure sharing and vetting of best practices to act as 

a force multiplier in Service based suicide prevention programs. 

IHS IHS refers AI/AN tribes and communities to the Tribal Prevention 

Specialists at the Suicide Prevention Resource Center. These SPRC 

Tribal Prevention Specialists participate on conference calls for the IHS 

Area suicide prevention programs and the US/Canada MOU Ad Hoc 

Working Group on Suicide Prevention. 

SAMHSA Completed-Suicide Prevention Resource Center (SPRC). 

VA VA has implemented the Mental Illness Research Education and Clinical 

Center in Denver as a center focused on biological and neuropsychiatric 

approaches, and the Center of Excellence in Canandaigua as a center 

focused on public health approaches for suicide prevention. It has 

developed the Serious Mental Illness Research Education and Clinical 

Center in Ann Arbor as a center focused on studies of veterans’ suicide 

rates, risk factors, and their regional variation. 

NSSP 5.1: By 2005, increase the proportion of primary care clinicians, 

other health care providers, and health and safety officials who routinely 

assess the presence of lethal means (including firearms, drugs, and 

poisons) in the home and educate about actions to reduce associated risks. 

AHRQ AHRQ currently supports research providing evidence for best practices. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians to include the 

availability of lethal means. 

IHS Physicians, and other health professions, and behavioral health staff 

routinely screen for depression and suicidal behaviors (including lethal 

means). Community mental health representatives and injury prevention 

staff provide technical assistance/consultations and grants in this area. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 38 of 62 

NIMH Staff provides technical assistance as requested; agency supports 

relevant research. Initiative for suicide prevention research in emergency 

departments intended to provide evidence base. 

VA VA requires clinical evaluations of the risk of suicide, including 

assessment of access to lethal means, in those who screen positive for 

mental health conditions. 

NSSP 5.2: By 2005, expose a proportion of households to public 

information campaign(s) designed to reduce the accessibility of lethal 

means, including firearms, in the home. 

AHRQ AHRQ currently supports a nationwide survey, the Healthcare Cost and 

Utilizations Project (HCUP), which is the largest collection of longitudinal 

hospital care data in the United States with all-payer, encounter-level 

information. Specific data on hospitalizations are included. 

IHS Community health representatives and injury prevention staff provide 

technical assistance. 

VA VA is implementing a gun safety program in each medical facility that will 

include the distribution of gun safety literature and gun locks. 

NSSP 5.3: By 2005, develop and implement improved firearm safety 

design using technology where appropriate. 

IHS The Injury Prevention program provides technical assistance/consultations 

and grants in this area. 

NSSP 5.4: By 2005, develop guidelines for safer dispensing of medications 

for individuals at heightened risk of suicide. 

AHRQ AHRQ supports research providing evidence for best practices. 

IHS Provides clinical policy and guidelines. Pharmacy, physicians, mental 

health staff and others are provided with appropriate training. 

VA VA is implementing a gun safety program in each medical facility, that will 

include the distribution of gun safety literature and gun locks. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 39 of 62 

NSSP 5.5: By 2005, improve automobile design to impede carbon 

monoxide-mediated suicide. 

CDC Staff provides technical assistance when requested and supports 

research. 

NSSP 5.6: By 2005, institute incentives for the discovery of new 

technologies to prevent suicide. 

DoD DoD is supporting research on creative efforts to prevent suicide through 

the Military Operational Medical Research Program. 

NSSP 6.1: By 2005, define minimum course objectives for providers of 

nursing care in assessment and management of suicide risk, and 

identification and promotion of protective factors. Incorporate this material 

into curricula for nursing care providers at all professional levels. 

AHRQ AHRQ supports research providing evidence for best practices. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians. 

IHS Staff provides clinical policy, guidelines and technical 

assistance/consultation in this area as needed. Training has been 

developed for health professionals including nurses to utilize a suicide 

surveillance form and depression screening in the electronic health record 

to identify and provide treatment to clients that are suicidal. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed Alliance. 

VA VA has extensive training activities for providers in areas such as the 

recognition, diagnosis, and treatment of mental health conditions, and pain 

management. In addition, there are programs specifically targeting suicide 

prevention more directly. VA has implemented mandatory training in 

suicide prevention for all VHA health care providers, and for all non-clinical 

staff that interacts with veterans. 
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NSSP Compendium-Final 3-27-09 Page 40 of 62 

NSSP 6.2: By 2005, increase the proportion of physician assistant 

educational programs and medical residency programs that include training 

in the assessment and management of suicide risk and identification and 

promotion of protective factors. 

AHRQ AHRQ supports research providing evidence for best practices. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians, to include the 

availability of lethal means. Area and local clinical policy and opportunities 

for training meet established requirements. 

IHS Area and local clinics provide clinical policy and opportunities for training 

to meet established requirements. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed alliance. 

VA VA has implemented mandatory training in suicide prevention for all VHA 

health care providers. 

NSSP 6.3: By 2005, increase the proportion of clinical social work, 

counseling, and psychology graduate programs that include training in the 

assessment and management of suicide risk, and the identification and 

promotion of protective factors. 

AHRQ Supports research providing evidence for best practices. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians. For example, 

all Navy psychology interns are exposed to seminars and training in 

suicide risk assessment by the American Association of Suicidology.

IHS Provides clinical policy and training requirements. In some Areas, IHS 

staff is collaborating with the Tribal colleges in the area of suicide 

prevention/intervention. IHS sponsors the American Indians into 

Psychology Program - which addresses the issue of suicide. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed alliance. 
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NSSP Compendium-Final 3-27-09 Page 41 of 62 

VA VA has implemented mandatory training in suicide prevention for all VHA 

health care providers 

NSSP 6.4: By 2005, Increase the proportion of clergy who have received 

training in identification of and response to suicide risk and behaviors and 

the differentiation of mental health disorders and faith crises. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by chaplains. For example, 

all Navy Chaplains receive basic training on suicide awareness and 

prevention techniques. Over and above this baseline, some chaplains 

receive clinical training as part of the Pastoral Care Residency (PCR) 

program, which is a run for the Chief of Navy Chaplains by the Bureau of 

Navy Medicine with support from the Department of Veteran’s Affairs. A 

key part of the PCR curriculum addresses suicide as it relates to spiritual 

crisis and mental disorders. 

IHS Staff is assisting AI/AN communities, including clergy and traditional 

healers, with obtaining culturally appropriate information and training on 

best and promising practices in suicide prevention and intervention. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed Alliance. 

VA VA has implemented mandatory training on suicide prevention for all VHA 

staff that interacts with veterans. Working through the Suicide Prevention 

Coordinators in each medical center, VA provides “guide” training on 

warning signs of suicide and the availability of effective treatment for 

individuals in the community including veterans, families, and staff from 

agency and organization. 

NSSP 6.5: By 2005, increase the proportion of educational faculty and staff 

who have received training on identifying and responding to children and 

adolescents at risk for suicide. 

DoD 100% of DoD personnel receive training annually on identifying and 

responding to suicide risk. 

ED Grants to local and state educational agencies and Indian Tribes to 

establish linkages between schools and mental health systems, to build 

capacity, provide professional development and expand services to help 

improve ability to identify risk and make appropriate referrals; staff 

provides technical assistance as requested. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 42 of 62 

HRSA The Stop Bullying Now Campaign—Take a Stand, Lend a Hand: This 

campaign included resources for young people, parents, and educators 

interested in bullying prevention. The campaign includes a web-based 

animated series, Public Service Announcements (PSA), and a Resource 

Kit. The two National School Based Mental Health Centers funded through 

the Maternal and Child Health Bureau. 

IHS Educational faculty and staff are provided opportunities for suicide 

prevention/intervention training at IHS national and regional conferences 

and summits. IHS staff to provide training at national, regional, and local 

education conferences and trainings when requested. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through Garrett Lee Smith (GLS) Grants.

NSSP 6.6: By 2005, increase the proportion of correctional workers who 

have received training on identifying and responding to persons at risk for 

suicide. 

DoD Although DoD has relatively few personnel working in corrections settings, 

all DoD personnel receive training annually on identifying and responding 

to suicide risk. 

IHS In some Areas, IHS, BIA and Tribes are collaborating to implement suicide 

prevention education/training to identify and to respond to persons at risk 

for suicide in BIA or Tribally funded correctional facilities. 

NIMH Supports research providing evidence for best practices. 

VA Working through the Suicide Prevention Coordinators in each medical 

center, VA provides “guide” training on warning signs of suicide and the 

availability of effective treatment for individuals in the community including 

veterans, families, and staff from relevant agencies and organizations. 

NSSP 6.7: By 2005, increase the proportion of divorce and family law and 

criminal defense attorneys who have received training in identifying and 

responding to persons at risk for suicide. 

DoD 100% of DoD personnel have received training annually on identifying and 

responding to suicide risk, including Judge Advocate General Corps 

attorneys and other legal staff personnel. 

NIMH Supports research providing evidence for best practices. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 43 of 62 

SAMHSA Through proposed Alliance. 

VA Working through the Suicide Prevention Coordinators in each medical 

center, VA provides “guide” training on warning signs of suicide and the 

availability of effective treatment for individuals in the community including 

veterans, families, and staff from agency and organizations. 

NSSP 6.8: By 2005, increase the proportion of counties (or comparable 

jurisdictions such as cities or tribes) in which education programs are 

available to family members and others in close relationships with those at 

risk for suicide. 

IHS IHS staff is assisting American Indian and Alaska Native consumers and 

their families, and communities with obtaining culturally appropriate 

information and training on best and promising practices in suicide 

prevention and intervention. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed Alliance. 

VA Working through the Suicide Prevention Coordinators in each medical 

center, VA provides “guide” training on warning signs of suicide and the 

availability of effective treatment for individuals in the community including 

veterans, families, and staff from agency and organizations As part of its 

ongoing education and outreach activities for veterans, VA has developed 

and disseminates psychoeducational materials about suicide prevention 

for veterans/families. 

NSSP 6.9: By 2005, increase the number of recertification or licensing 

programs in relevant professions that require or promote competencies in 

depression assessment and management and suicide prevention. 

NIMH Supports research providing evidence for best practices. 

SAMHSA Through proposed Alliance 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 44 of 62 

NSSP 7.1: By 2005, increase the proportion of patients treated for selfdestructive behavior in hospital emergency departments that pursue the 

proposed mental health follow-up plan. 

CDC Supports research in this area. 

DoD The Services train their medical and mental health providers and staff on 

the proper suicide risk assessment and treatment. For example, the Air 

Force has developed the Air Force Guide for Managing Suicidal Behavior 

and the Clinical Management of Suicidal Behavior Policy. 

IHS IHS physicians, other emergency personnel, and behavioral health staff 

routinely screen for depression and suicide behaviors (including lethal 

means). There are depression screening tools and suicide surveillance 

tools available on the patient’s electronic health record. One primary care 

based behavioral health intervention is the Alcohol Screening Brief 

Intervention, which our agency is broadly promoting as an integral part of 

emergency and primary care. 

NIMH Collaboration with AFSP to support ED patient registry to track and followup care. Supports research providing evidence for best practices. 

Initiative for suicide prevention research in emergency departments 

intended to provide evidence base. 

SAMHSA Sponsored meeting of researchers, national organizations, and 5 Federal 

agencies to examine current knowledge and next steps to increase mental 

health follow-up for self destructive patients treated in hospital emergency 

departments. 

VA Emergency departments in VA Medical Centers have 24/7 mental health 

coverage. Medical Centers and Community Based Outpatient Clinics that 

do not have Emergency Departments or 24/7 Urgent Care Centers are 

developing understandings with community emergency departments to 

facilitate the availability of mental health emergency care services on a 

24/7 basis. VA provides educational outreach to mental health and 

primary care providers in the community who may see veterans or their 

families to promote awareness of the invisible wounds of way, of military 

and veteran’s culture, and the availability of services through VA. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 45 of 62 

NSSP 7.2: By 2005, develop guidelines for assessment of suicidal risk 

among persons receiving care in primary health care services, emergency 

departments, and specialty mental health and substance abuse treatment 

centers, implement these guidelines in a proportion of these settings. 

AHRQ AHRQ supports research providing evidence for best practices. 

CDC Supports research in this area. 

DoD The Services train their medical and mental health providers and staff on 

the proper suicide risk assessment and treatment. For example, The Air 

Force has developed the Air Force Guide for Managing Suicidal Behavior 

and the Clinical Management of Suicidal Behavior Policy and along with 

the Marine Corps has trained their staff with 1-day AAS/SPRC curriculum, 

“Assessing and Managing Suicide Risk.” 

HRSA Mental Health and Substance Abuse Expansion Grants seek to expand 

the capacity of Community Health Centers to provide high quality mental 

health/substance abuse care. These grants fund the establishment of 

new or the expansion of existing mental health/substance abuse treatment 

services in Community Health Centers. The Health Disparities 

Depression Collaborative works to ensure that Community Health Centers 

implement and maintain a population-based care model to improve 

depression assessments and care, as well as demonstrate improved 

health care outcomes. 

IHS IHS and Tribal physicians, other emergency personnel, behavioral health 

and substance abuse treatment staff routinely screen for depression and 

suicidal behaviors (including lethal means). There are depression 

screening tools and suicide surveillance tools available on the patient’s 

electronic health record. 

NIMH Collaboration with AFSP to support ED patient registry to track follow up 

care. Current initiative for suicide prevention research in emergency 

departments intended to provide evidence base. Supports research in 

providing evidence for best practices. 

SAMHA Suicide Prevention Resource Center developed Suicide Assessment FiveStep Evaluation and triage care (SAFE-T). National Suicide Prevention 

Lifeline developed suicide risk assessment standards which have been 

implemented in all National Suicide Prevention Lifeline crisis centers. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 46 of 62 

VA VA’s suicide prevention program is based on the general principles that 

effective suicide prevention requires both public health and clinical 

programs, and that the clinical activities must include ready access to high 

quality mental health services as well as programs directed specifically 

toward suicide prevention. VA integrates services for the evaluation and 

treatment of mental health conditions into primary care, and other medical 

care settings. 

NSSP 7.3: By 2005, increase the proportion of specialty mental health and 

substance abuse treatment centers that have policies, procedures, and 

evaluation programs designed to assess suicide risk and intervene to 

reduce suicidal behaviors among their patients. 

AHRQ AHRQ supports research providing evidence for best practices. 

 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians, to include the 

availability of lethal means. 

IHS IHS Manual is currently being revised. The Indian health system 

behavioral health and substance abuse staff routinely screen for 

depression and suicidal behaviors (including lethal means). There are 

depression screening tools and suicide surveillance tools available on the 

patient's electronic health record. 

NIMH Staff provides technical assistance as requested; relevant research 

supported by agency. 

SAMHSA The Suicide Prevention Resource Center is working with the State Mental 

Health Program Directors (NASMPD) on the development of technical 

paper on the role of the State Mental Health Authority in suicide 

prevention. 

VA VA’s suicide prevention program is based on the general principles that 

effective suicide prevention requires both public health and clinical 

programs, and that the clinical activities must include ready access to high 

quality mental health services as well as community-based programs 

supporting help-seeking, and clinical program directed specifically toward 

suicide prevention. VA is a national system, and its policies are 

implemented in each of its medical centers and clinics. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 47 of 62 

NSSP 7.4: By 2005, develop guidelines for aftercare treatment programs 

for individuals exhibiting suicidal behavior (including those discharged from 

inpatient facilities). Implement these guidelines in a proportion of these 

settings. 

DoD DoD has policy and training in place to encourage the appropriate 

assessment and management of suicide risk by clinicians, to include the 

availability of lethal means. 

IHS IHS Manual is currently being revised. Staff provides technical assistance 

as requested. 

NIMH Staff provides technical assistance as requested; relevant research 

supported by agency. 

SAMHSA The Suicide Prevention Resource Center (SPRC) is collaborating with the 

American Association of Suicidology to prepare a summary of existing 

research and resources on continuity of care for patients discharged from 

emergency departments and inpatient units. 

VA VA has national requirements for continuity of care and timely follow-up for 

those discharged from inpatient mental health units, and residential care 

programs, as well as those seeking emergency care for problems related 

to mental health conditions. 

NSSP 7.5: By 2005, increase the proportion of those who provide key 

services to suicide survivors (e.g., emergency medical technicians, 

firefighters, law enforcement officers, funeral directors, and clergy) who 

have received training that addresses their own exposure to suicide and 

the unique needs of suicide survivors. 

AHRQ AHRQ currently supports a nationwide survey, the Healthcare Cost and 

Utilizations Project (HCUP), which is the largest collection of longitudinal 

hospital care data in the United States with all-payer, encounter-level 

information. Specific data on hospitalizations are included. 

DoD DoD has been training mental health personnel, chaplains, community 

agencies, and peer facilitators on Critical Incident Stress Management and 

Traumatic Stress Response for nearly a decade. Newer training focuses 

on Psychological First Aid models. Every installation has trained teams 

ready to respond to the needs of first responders and other trauma 

victims. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 48 of 62 

IHS In some Areas, staff is providing training (e.g. Traumatic Stress 

Response/CISM services) to IHS and Tribal Emergency Response 

personnel, as well as community members including law enforcement, 

clergy and others. The IHS Emergency Medical Services/Preparedness 

Division is supporting AI/AN communities by utilizing the IHS Emergency 

Response to Suicide Model to assess communities with high incidence of 

suicide, coordinate a response to the affected community, and augment 

existing staff, with the goal of mitigating the emergency and stabilizing the 

community. This response has included training provided to law 

enforcement, emergency personnel, emergency medical technicians, and 

other service providers. 

NIMH Staff provides technical assistance as requested; relevant research 

supported by agency. 

SAMHSA Suicide Prevention Resource Center is developing a curriculum to be used 

for this purpose. 

NSSP 7.6: By 2005, increase the proportion of patients with mood 

disorders who complete a course of treatment or continue maintenance 

treatment as recommended. 

AHRQ AHRQ supports research providing evidence for best practices. 

DoD DoD provides free healthcare to all beneficiaries and provides active 

outreach through its suicide prevention program to encourage 

beneficiaries with mental health concerns to seek treatment. 

HRSA Mental Health and Substance Abuse Expansion Grants seek to expand 

the capacity of Community Health Centers to provide high quality mental 

health/substance abuse care. These grants fund the establishment of 

new or the expansion of existing mental health/substance abuse treatment 

services in Community Health Centers. The Health Disparities 

Depression Collaborative works to ensure that Community Health Centers 

implement and maintain a population-based care model to improve 

depression assessments and care, as well as demonstrate improved 

health care outcomes. 

IHS IHS Manual is currently being revised to include treatment and follow-up. 

NIMH Agency currently supports grants on this. 

VA VA utilizes quality and performance indicators throughout its system to 

monitor the quality of care for mood disorders, as well as other mental 

health conditions. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 49 of 62 

NSSP 7.7: By 2005, increase the proportion of hospital emergency 

departments that routinely provide immediate post-trauma psychological 

support and mental health education for all victims of sexual assault and/or 

physical abuse. 

DoD DoD has been training mental health personnel, chaplains, community 

agencies, and peer facilitators on Critical Incident Stress Management and 

Traumatic Stress Response for nearly a decade. Every installation has 

trained teams ready to respond to the needs of trauma victims. In addition, 

DoD has deployed an aggressive sexual assault prevention and response 

program, both to prevent such assaults and to ensure victims are afforded 

the full spectrum of medical, legal, and other support services available. 

IHS In some Areas, staff is providing training (e.g. Traumatic Stress 

Response/CISM services) to IHS and Tribal Emergency Response 

personnel. The IHS Manual is currently being revised to include a sexual 

assault policy. The IHS and Administration for Children and Families 

(ACF) are jointly funding a competitive cooperative agreement for 

Violence Against Women (VAW) Pilot Program. The program aims to 

improve the responsiveness of tribal and urban Indian health facilities that 

provide care to AI/AN females aged 13 and above who have experienced 

domestic violence and sexual assault. 

NIMH Staff provides technical assistance as requested; relevant research 

supported by agency. 

VA VA screens all veteran patients for histories of military sexual trauma, and 

expedites further evaluations and treatment for those who screen positive. 

NSSP 7.8: By 2005, develop guidelines for providing education to family 

members and significant others of persons receiving care for the treatment 

of mental health and substance abuse disorders with risk of suicide. 

Implement the guidelines in facilities (including general and mental 

hospitals, mental health clinics, and substance abuse treatment centers). 

DoD Services provide marketing materials including posters and brochures that 

are available at military treatment facilities to educate patients and family 

members on suicide risk, warning signs and protective factors. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 50 of 62 

HRSA Perinatal Depression Booklet: The goals of the entire Perinatal 

Depression Initiative, including this booklet, are to reduce stigma 

associated with perinatal depression, increase the number of women and 

families who seek treatment, increase the number of providers who 

recognize the symptoms of perinatal depression, and to provide screening 

for perinatal depression 

IHS IHS Manual is currently being revised and addresses the treatment of 

mental health and substance abuse disorders including those at risk of 

suicide. 

NIMH Staff provides technical assistance as requested; relevant research 

supported by agency. 

VA Working through the Suicide Prevention Coordinators in each medical 

center, VA provides “guide” training on warning signs of suicide and the 

availability of effective treatment for individuals in the community including 

veterans, families, and staff from agency and organizations. As part of its 

ongoing education and outreach activities, as well as a component of care 

for veterans, VA has developed and disseminates psychoeducational 

materials about suicide prevention for veterans and families. 

NSSP 7.9: By 2005, incorporate screening for depression, substance 

abuse and suicide risk as a minimum standard of care for assessment in 

primary care settings, hospice, and skilled nursing facilities for all Federallysupported healthcare programs (e.g., Medicaid, CHAMPUS/TRICARE, 

CHIP, Medicare). 

AHRQ AHRQ currently supports providing evidence for best practices. 

DoD All military personnel receive screening for mental health concerns 

annually, prior to deployments, immediately upon return from 

deployments, and 90-180 days after returning from deployments. 

HRSA Mental Health and Substance Abuse Expansion Grants seek to expand 

the capacity of Community Health Centers to provide high quality mental 

health/substance abuse care. These grants fund the establishment of 

new or the expansion of existing mental health/substance abuse treatment 

services in Community Health Centers. The Health Disparities 

Depression Collaborative works to ensure that Community Health Centers 

implement and maintain a population-based care model to improve 

depression assessments and care, as well as demonstrate improved 

health care outcomes. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 51 of 62 

IHS IHS and some Tribal clinics and hospital staff are utilizing depression 

screening and suicide surveillance tools available on the patient's 

electronic health record. Staff also routinely uses alcohol assessment 

tools (e.g. CAGE). IHS is implementing the alcohol screening and brief 

intervention (ASBI) program and has developed guidelines for 

implementation. IHS manual is currently being revised and will provide 

guidelines for screening. 

NIMH Staff disseminates Joint Commission patient safety goals; relevant 

research supported by agency. 

VA VA requires periodic screening for depression, post-traumatic stress 

disorder, and problem-drinking in all of its health care programs. It 

requires clinical evaluations of the risk of suicide in all patients who screen 

positive. 

NSSP 7.10: By 2005, include screening for depression, substance abuse 

and suicide risk as measurable performance items in the Health Plan 

Employer Data and Information Set (HEDIS). 

AHRQ Agency working with partners. 

IHS Clinics and hospital staff are using depression screening and suicide 

surveillance tools available on the patient's electronic health record. Staff 

also routinely use alcohol assessment tools (e.g. CAGE). IHS is 

implementing an ASBI program. IHS GPRA measures now include 

screening for depression in primary care settings as best practice in order 

to assist in identifying patients at risk for developing suicidal ideation. IHS 

has consistently met or exceeded target goals for this GPRA depression 

screening measure. 

NIMH Agency supports relevant research. 

VA VA includes screening and follow-up for positive screens for depression, 

post-traumatic stress disorder, and problem drinking among the indices it 

follows in its quality and performance program.

NSSP 8.1: By 2005, increase the number of States that require health 

insurance plans to cover mental health and substance abuse services on 

par with coverage for physical health. 

NIMH Supports research assessing costs, benefits and quality of care. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 52 of 62 

NSSP 8.2: By 2005, increase the proportion of counties (or comparable 

jurisdictions) with health and/or social services outreach programs for atrisk populations that incorporate mental health services and suicide 

prevention. 

NIMH Supports research assessing costs, benefits and quality of care. 

VA The responsibilities of the Suicide Prevention Coordinators in each facility 

include outreach and liaison with community agencies and organizations. 

VA conducts outreach to enrolled and eligible veterans through Vet Center 

programs, and other mechanisms. 

NSSP 8.3: By 2005, define guidelines for mental health (including 

substance abuse) screening and referral of students in schools and 

colleges. Implement those guidelines in a proportion of school districts and 

colleges. 

CDC Agency reviews & recommends policies in this area. 

ED Grants to local and state educational agencies to create protocols and 

improve access to mental health services; grants to institutions of higher 

education, and other public and private nonprofit organizations to address 

alcohol use and high risk drinking; staff provides technical assistance as 

requested. 

IHS IHS Manual is currently being revised to include information on providing 

mental health screening and referral guidelines and policy. Some IHS 

behavioral health staff work closely with school personnel to provide 

technical assistance/consultation, and behavioral health services to 

students. 

NIMH Agency supports relevant research. Current initiative on college mental 

health research; using ARRA funds. 

NSSP 8.4: By 2005, develop guidelines for schools on appropriate linkages 

with mental health and substance abuse treatment services and implement 

those guidelines in a proportion of school districts. 

CDC Agency reviews & recommends policies in this area. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 53 of 62 

ED Grants to educational agencies, local educational agencies and Tribes to 

establish linkages between schools and mental health systems, to build 

capacity and expand services; staff provides technical assistance as 

requested. 

IHS Manual is currently being revised to include information on mental health 

and substance abuse treatment guidelines and policy. Some IHS 

behavioral health staff work closely with school personnel to provide 

technical assistance/consultation, and behavioral health services to 

students. 

NIMH Agency supports relevant research.

NSSP 8.5: By 2005, increase the proportion of school districts in which 

school-based clinics incorporate mental health and substance abuse 

assessment and management into their scope of activities. 

ED Grants to state educational agencies, local educational agencies and 

Indian Tribes to establish linkages between schools and mental health 

systems, to build capacity and expand services; staff provide technical 

assistance as requested. Several recipients have addressed SBHC’s. 

HRSA HRSA funds the National Assembly of School Based Health Centers 

which is expanding Mental Health programs in their affiliated centers. 

IHS IHS Manual is currently being revised to include information on mental 

health and substance abuse treatment guidelines and policy. Some IHS 

behavioral health staff work closely with school personnel to provide 

technical assistance/consultation, and behavioral health and school based 

health clinics to students. 

NIMH Agency supports relevant research. 

NSSP 8.6: By 2005, for adult and juvenile incarcerated populations, define 

national guidelines for mental health screening, assessment and treatment 

of suicidal individuals. Implement the guidelines in correctional institutions, 

jails and detention centers. 

NIMH Agency supports relevant SBIR research. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 54 of 62 

IHS IHS Manual is currently being revised to include information on guidelines 

for mental health screening, assessment and treatment of suicidal 

individuals. In some Areas, IHS, BIA and Tribes are collaborating and 

implementing guidelines to provide mental health screening, assessment 

and treatment for American Indian and Alaska Natives who are 

incarcerated.

NSSP 8.7: By 2005, define national guidelines for effective comprehensive 

support programs for suicide survivors. Increase the proportion of counties 

(or comparable jurisdictions); in which the guidelines are implemented. 

DoD Services are encouraging more robust postvention efforts. For example, 

the Marine Corps added a section on postvention to their suicide 

prevention website, work with the Tragedy Assistance Program for 

Survivors (TAPS) and engage survivors interested in working with the 

suicide prevention program. Further, the annual Military Suicide 

Prevention Program included numerous workshops and presentations by 

and for survivors in January 2009. 

NIMH Agency supports relevant research. 

NSSP 8.8: By 2005, develop quality care/utilization management guidelines 

for effective response to suicidal risk or behavior and implement these 

guidelines in managed care and health insurance plans. 

IHS Manual is currently being revised to include information on guidelines and 

policy for managing suicidal behavior guidelines. 

NIMH Agency supports relevant research. 

NSSP 9.1: By 2005, establish an association of public and private 

organizations for the purpose of promoting the accurate and responsible 

representation of suicidal behaviors, mental illness and related issues on 

television and in movies. 

NIMH Agency coordinates with SAMHSA in Entertainment Industry Council 

awards. 

SAMHSA With Entertainment Industries Council supports annual PRISM awards 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 55 of 62 

VA VA works with the Federal Partners Work Group of Suicide Prevention 

and relevant academic partners to promote the ethical and responsible 

reporting of suicide in news reports, and its depiction in entertainment 

media. 

NSSP 9.2: By 2005, increase the proportion of television programs and 

movies that observe promoting accurate and responsible depiction of 

suicidal behavior, mental illness and related issues. 

NIMH Agency coordinates with SAMHSA in Entertainment Industry Council 

awards. 

SAMHSA Along with Entertainment Industries Council and NIMH, supports PRISM 

awards. Along with Entertainment Industries Council supports “Picture 

This: Depression and Suicide Prevention”, a meeting to bring together 

television and film writers and suicide prevention experts to develop 

recommendations. 

VA VA works with the Federal Partners Work Group of Suicide Prevention 

and relevant academic partners to promote the ethical and responsible 

reporting of suicide in news reports, and its depiction in entertainment 

media. 

NSSP 9.3: By 2005, increase the proportion of news reports on suicide that 

observe consensus reporting recommendations. 

CDC Collaboration with AFSP & Annenberg Foundation. 

DoD The Service Suicide Prevention Programs work closely with Service and 

DoD Public Affairs Officers to ensure coverage of suicides is accurate and 

appropriate, and to regularly release suicide prevention messages and 

information. 

NIMH Collaborated with Annenberg Foundation on earlier survey. 

VA VA works with the Federal Partners Work Group of Suicide Prevention 

and relevant academic partners to promote the ethical and responsible 

reporting of suicide in news reports, and its depiction in entertainment 

media. 
SECTION 2: INTERVENTION 

NSSP Compendium-Final 3-27-09 Page 56 of 62 

NSSP 9.4: By 2005, increase the number of journalism schools that include 

in their curricula guidance on the portrayal and reporting of mental illness, 

suicide and suicidal behaviors. 

NIMH Collaborated with the Annenberg foundation and provided guidance for 

Carter Center Journalism Fellowships. 

VA VA works with the Federal Partners Work Group of Suicide Prevention 

and relevant academic partners to promote the ethical and responsible 

reporting of suicide in news reports, and its depiction in entertainment 

media. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 57 of 62 

SECTION 3: METHODOLOGY 

PROMOTE AND SUPPORT RESEARCH ON SUICIDE AND SUICIDE 

PREVENTION 

NSSP 10.1: By 2002, develop a national suicide research agenda with 

input from survivors, practitioners, researchers, and advocates. 

CDC Agency developed a research agenda. 

DoD The Defense Centers of Excellence on Psychological Health and 

Traumatic Brain Injury promotes research through a research directorate. 

The Army acts as an executive agent for numerous DoD research 

programs including Military Operational Medicine Research Program 

which currently manages RFAs for grant moneys in suicide prevention 

research. The Services collaborate with academic institutions such as the 

Uniformed Services University of the Health Sciences (USUHS), the 

University of Rochester, and the Catholic University of America. The 

Rand Corporation is conducting a study of DoD suicide prevention 

programs and the Army and Marine Corps are collaborating with NIMH on 

a 5-year longitudinal study of suicide factors. 

IHS The Tribal Epidemiology Centers are developing increasing interest in 

behavioral health concerns. The Tribal Epidemiology Centers, CDC, and 

IHS convene regular conference calls to discuss injury-related subjects, 

including suicidal behavior. IHS and NIH collaborate on NARCH grants in 

which a few are addressing suicide research. 

NIMH Agency has period research initiatives informed by workshops that include 

researchers and advocates (survivors, practitioners). 

NSSP 10.2: By 2005, increase funding (public and private) for suicide 

prevention research, for research on translating scientific knowledge into 

practice, and for training of researchers in Suicidology. 

AHRQ AHRQ supports research providing evidence for best practices. 

DoD The Military Operational Medicine Research Program is reviews 

applications for DoD grant moneys in suicide prevention research. The 

Uniformed Services University of Health Sciences engages in a program 

of suicide prevention and intervention research. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 58 of 62 

HRSA Perinatal Depression Grant provides funding to several communities for 

research on maternal and infant mental health services 

IHS NARCH grant provided funding to several communities for research on 

suicide prevention. Collaboration between IHS, NIH, and Tribal 

communities is currently underway. 

NIMH Supports training and education grants on research in suicide prevention. 

NSSP 10.3: By 2005, establish and maintain a registry of prevention 

activities with demonstrated effectiveness for suicide or suicidal behaviors. 

SAMHSA Suicide Prevention Resource Center (SPRC), SAMHSA. 

NSSP 10.4: By 2005, perform scientific evaluation studies of new or 

existing suicide prevention interventions. 

CDC Agency supports relevant research. 

DoD The Military Operational Medicine Research Program is reviews 

applications for DoD grant moneys in suicide prevention research. The 

Uniformed Services University of Health Sciences engages in a program 

of suicide prevention and intervention research and is studying specific 

Marine Corps initiatives. Rand Corporation is conducting a study of all 

DoD suicide prevention programs’ effectiveness. 

HRSA Journal Article commissioned by the MCHB about New Jersey’s Best 

Practices to prevent adolescent suicide. 

IHS NARCH grant provided funding to several communities for research on 

suicide prevention. Collaboration has occurred between IHS, NIH, and 

Tribal communities. 

NIMH Agency supports relevant research. 

SAMHSA Suicide prevention evaluations. 

NSSP 11.1: By 2005, develop and refine standardized protocols for death 

scene investigations and implement these protocols in counties (or 

comparable jurisdictions). 

CDC Collaboration with National Association of Medical Examiners. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 59 of 62 

DoD Each Service’s investigative bodies (i.e., AFOSI, NCIS, CID) have wellestablished standardized procedures for death scene investigations. 

NIMH Plans to support meeting of suicide prevention researchers with national 

violent death reporting system (NVDRS) staff to address this. 

NSSP 11.2: By 2005, increase the proportion of jurisdictions that regularly 

collect and provide information for follow-back studies on suicides. 

CDC Agency supports National Violent Death Reporting System. 

DoD Each Service collects and analyzes data on suicides, and DoD has 

standardized data collection through the implementation of the DoD 

Suicide Event Report in use by all Services and managed at the Center of 

Excellence in Telehealth and Technology, a center of the Defense Centers 

of Excellence on Psychological Health and Traumatic Brain Injury. 

HRSA Maternal and Child Health Title V National Performance Measure 16 

related to adolescent suicide rates. 

IHS IHS has developed a suicide surveillance reporting tool to document 

incidents of suicide in a standardized and systematic fashion. This tool is 

part of the RPMS health information system and is available to all 

providers. The Suicide Reporting Database is beginning to provide a more 

detailed picture of who is committing or attempting suicide and identifies 

salient factors contributing to the events. Accurate and timely data 

captured at the point of care provides important clinical and 

epidemiological information that can be used to inform intervention and 

prevention efforts. 

NIMH There are depression screening tool and suicide surveillance tools 

available on the patient's electronic health record. Also, regularly collect 

data on suicide ideation, gestures, attempts, and completions at IHS and 

some Tribal clinics and hospitals. IHS has a depression screening GPRA 

indicator. Plans to support meeting of suicide prevention researchers with 

national violent death reporting system (NVDRS) staff to address this. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 60 of 62 

NSSP 11.3: By 2005, increase the proportion of hospitals (including 

emergency departments) that collect uniform and reliable data on suicidal 

behavior by coding external cause of injuries, utilizing the categories 

included in the International Classification of Diseases. 

AHRQ AHRQ currently supports a nationwide survey, the Healthcare Cost and 

Utilization Project (HCUP), which is the largest collection of longitudinal 

hospital care data in the United States with all-payer, encounter-level 

information. Specific data on suicide-related hospitalizations are included. 

CDC Active project. 

IHS Clinics and hospital staff are using depression screening and suicide 

surveillance tools available on the patient's electronic health record. They 

are able to record data utilizing ICD codes. 

NIMH Current initiative on suicide prevention in emergency departments 

requests reliable approach to screening, triage, and follow-up. 

NSSP 11.4: By 2005, implement a national violent death reporting system 

that includes suicides and collects information not currently available from 

death certificates. 

CDC Active project. 

NIMH Will pursue opportunity to expand to psychosocial autopsy study.

NSSP 11.5: By 2005, increase the number of States that produce annual 

reports on suicide and suicide attempts, integrating data from multiple State 

data management systems. 

CDC Agency supports this activity in Core injury states & through STIPDA. 

DoD Each Service produces annual reports on lessons learned from active duty 

suicides, drawing on data from multiple sources to provide a complete 

picture of suicide trends and risk factors. These reports influence the 

development of suicide prevention initiatives. 

HRSA Title V National Performance Measure 16 relating to youth suicide 

reported annually in the Title V Maternal and Child Health Block Grant 

Application. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 61 of 62 

IHS IHS is developing an IHS-wide Behavioral Health “data mart” to provide 

IHS leadership with up-to-date information on Suicidal events including 

Suicide Completions. The application will include a number of available 

reports and will provide the ability to identify “cluster” events to assist in 

the mobilization and deployment of available resources. IHS will also 

publish an Indian Health Focus report on Behavioral Health which will 

include suicide data. Clinics and hospital staff there are using depression 

screening and suicide surveillance tools available on the patient's 

electronic health record. There is a GPRA indicator for screening for 

depression. Data collected in data warehouse. 

NIMH Supports research initiative for states to collect relevant data and 

collaborate with other states to assess various policies. 

SAMHSA Suicide Prevention Resource Center monitors and posts on its website 

state suicide prevention activity, including annual reports. 

NSSP 11.6: By 2005, increase the number of nationally representative 

surveys that include questions on suicidal behavior. 

AHRQ AHRQ currently supports a nationwide survey, the Healthcare Cost and 

Utilization Project (HCUP), which is the largest collection of longitudinal 

hospital care data in the United States with all-payer, encounter-level 

information. Specific data on suicide-related hospitalizations are included. 

CDC Agency supports current projects such as YRBS. 

DoD Multiple DoD surveys include questions about suicidality, such as the DoD 

Survey of Health-Related Behavior and the DoD Quality of Life Survey. 

HRSA Uniform Data Source for Community Health Centers. 

NIMH Agency is reviewing current surveys. 

SAMHSA SAMHSA’s Office of Applied Studies included questions on suicidal 

ideation, plans, and attempts in the 2008 National Survey on Drug Use 

and Health (NSDUH). Questions were asked of adults aged 18 and over 

in an expanded Mental Health Module developed for the 2008 survey. 

The practice of providing all NSDUH interview respondents with the tollfree number for the National Suicide Prevention Lifeline (1-800 TALK) will 

be continued. It is anticipated that SAMHSA’s suicide data will be 

published in the Results from the 2008 National Survey on Drug Use and 

Health: National Findings report, Fall 2009. 
SECTION 3: METHODOLOGY 

NSSP Compendium-Final 3-27-09 Page 62 of 62 

NSSP 11.7: By 2005, implement pilot projects in several States that link 

and analyze information related to self-destructive behavior derived from 

separate data systems, including for example law enforcement, emergency 

medical services, and hospitals. 

CDC Agency activity with National Violent Death Reporting System (NVDRS) to 

address fatalities. 

HRSA State Agency Partnerships to improve Mental Health for Children and 

Adolescents, and Bright Futures for Women’s Health and Wellness 

through the Office of Women’s Health. 

IHS Data is collected nationally from across IHS areas and facilities into and 

IHS national data warehouse. 

NIMH Supports research initiative for states to collect relevant data and 

collaborate with other states to assess various policies.