Suicide prevention standards address public health crisis

Standards support the National Strategy for Suicide Prevention’s goal to reduce annual suicide rate by 20% over next eight years

Last year, the Centers for Disease Control and Prevention (CDC) reported that the suicide rate in the United States increased 24%, from 10.5 to 13.0 per 100,000 people, between 1999 and 2014. Further, it reported that the rate of increase has accelerated since 2006. Suicide has become one of the only public health issues where people are dying at a significantly higher rate today than they were 20 years ago.

This is the reality facing behavioral health providers who work on the front lines of this growing problem and interact with individuals at risk for suicide. Data show that a large percentage of people who experience suicide had previously interacted with the behavioral healthcare system in some way. Although this shows the opportunity for intervention exists, professionals seeking direction, background, or resources on how to prepare and contribute to a standardized public health response may not find much information when they search for it.

“In the United States, someone dies by suicide every 13 minutes. For veterans, that rate is roughly every 70 minutes,” says Michael Johnson, CARF’s managing director of Behavioral Health. “This is happening every hour, 24 hours per day, 365 days per year. But we don’t talk about it; it doesn’t consume our news cycle. We are responding to a crisis. We need to strengthen and mainstream a response that can get traction on a broad scale.”

Toward this end, CARF convened nine suicide-prevention experts in late 2016 for an International Standards Advisory Committee (ISAC), and then conducted a field review in early 2017 to gather input for comprehensive suicide prevention program standards. Those standards have now been released and was put into use with the 2017 Behavioral Health Standards Manual, which took effect July 1, 2017.

The standards manual supplement contains standards as well as survey preparation questions that assist service providers in conducting a self-evaluation. CARF is encouraging accredited programs in the behavioral healthcare arena to review the complimentary publication and consult with their resource specialist for more information if they are interested in seeking accreditation in this area.

CARF’s president and CEO, Brian Boon, Ph.D., who also serves on the executive committee of the National Action Alliance for Suicide Prevention (Action Alliance), said of the new standards, “CARF’s comprehensive suicide prevention program standards create vigilance toward this serious public health matter and provide a blueprint for the development of intervention services and systems for competent, timely, and empathetic care for persons and families struggling with this challenging issue. It also supports the Action Alliance’s National Strategy for Suicide Prevention. Continuous improvement efforts like this will help improve and deliver needed services to those persons at risk for suicide.”

Among the nine experts who sat on the 2016 ISAC was Heather Stokes, LCSW, vice president of strategic development at LivingWorks, a suicide intervention training company working in more than 30 countries. “So many organizations have a passion and commitment to reduce suicide, but they are unclear how to implement effective programs,” says Stokes. “These standards set a clear path, reflect advancements in the field of suicide prevention, and give leaders confidence that their programs are anchored to best practices. They also provide a concrete structure to identify and close organizational gaps in order to advance the standard of care and save lives.”

Other members of the ISAC included representatives from the Suicide Prevention Resource Center/EDC, U.S. Department of Veterans Affairs, U.S. Department of Defense, U.S. National Guard Bureau, U.S. Air National Guard, Tragedy Assistance Program for Survivors (TAPS), and SAMHSA.

Behavioral health service providers interested in accreditation for a comprehensive suicide prevention program should contact CARF at (888) 281-6531 or