Federally funded suicide prevention programs might have helped avert more than 79,000 suicide attempts by young people over a 3-year period, said authors of a national observational study.
Counties that implemented the comprehensive, community-based programs reported about 5 fewer suicide attempts for every 1,000 young people aged 16-23 years, compared with counties that were otherwise similar but lacked the programs, said Lucas Godoy Garraza of ICF International, New York, and his associates.
Since 2004, the Garrett Lee Smith (GLS) Memorial Act has channeled competitive federal grants to states, colleges, and tribes for youth suicide prevention programs. These initiatives include activities aimed at increasing suicide awareness; screening at-risk youth; training gatekeepers; and connecting young people and families with mental health care, survivor support programs, and crisis hotlines, the investigators said. A prior study tied the programs to short-term drops in rates of completed suicides, they noted (JAMA Psychiatry. 2015 Oct 14. doi: 10.1001/jamapsychiatry.2015.1933). To explore the effects of the GLS program on youth suicide attempts, the investigators compared National Survey on Drug Use and Health data for 466 counties that had implemented the programs and 1,161 counties that had not but were otherwise similar. The final dataset included 46 states and 12 tribal communities, the researchers said.
A year after implementing GLS-funded programs, counties averaged 4.9 fewer suicide attempts per 1,000 youths than did control counties (95% confidence interval, 1.8-8.0; P = .003). “Although causality cannot be definitively inferred from our study owing to a lack of random assignment, these results suggest that more than 79,000 attempts were avoided between 2008 and 2011 following implementation of the GLS program,” the investigators added.
The results, however, were not durable. Two years after program implementation, rates of suicide attempts in GLS counties again resembled those of non-GLS counties, mirroring findings from the study of suicide mortality, the investigators said. “Many factors not directly addressed by the present study likely contribute to these results,” they added. “Assessments of comprehensive suicide prevention programs in other contexts have suggested that adherence and focus on comprehensive suicide prevention activities may fade over time. The present results do not suggest that the GLS program activities were effective only once but, rather, that effectively preventing suicides requires continued implementation of program activities.”
The Substance Abuse and Mental Health Services Administration funded the study. Richard McKeon, Ph.D., one of the authors, is employed by SAMHSA. The other investigators declared no conflicts of interest.