Strategic Principles

Some of the components your workgroup will want to consider including in your organization’s suicide prevention plan are a statement of purpose, demographic and/or utilization data, metrics and evaluation methods, communication objectives and key messages. The information below will help guide your group in creating a comprehensive suicide prevention plan.

To help you establish a sound suicide prevention strategy, we have pulled together a variety of materials including:

Senior Management
Articles
Tip Sheets
Posters
Banner Graphics
Self-Scoring Quiz
E-mail Messages

Statement of purpose
The statement of purpose is the foundation of your suicide prevention effort; it acknowledges the scope of the problem, commits to supporting the workforce and expresses the core objectives that must be achieved.

Here is an example of such a statement, from the successful Air Force program:
“The United States Surgeon General has stated that suicide prevention is everyone’s business. The Air Force agrees with this and sees suicide as a problem of the entire Air Force community. The prevention of suicide must be recognized and solved at the community level through the development of awareness about suicide, the associated risk factors of suicide and how to modify these risk factors. The ultimate goal is to build this awareness and the principles of prevention into the ordinary activities of everyday life and into community structures. Early requests for help for self, and encouraging others to do the same, is the key to increasing the opportunity for intervention to help prevent suicide. The Air Force is committed to building a strong community among its members. Social connections save lives.”

Demographics and utilization data
Your plan should acknowledge the unique demographics of your workforce, such as:

• male/female ratio
• average age
• workplace diversity
• educational levels
• population type
• urban versus rural locations

You will want to gather relevant data on the overall utilization of employee assistance program and mental health and substance abuse services, as well as the prevalence of diagnoses of mood disorders, such as depression and bipolar disorder, substance abuse disorders and impulse disorders. Also, you will want data on suicides and attempted suicides.

This information will guide your decisions about strategy, objectives and tactics.

Establishing program standards
Based upon your organization’s demographic and relevant utilization data, you might want to establish program standards and measurement methods for evaluating the success of the program. Keep in mind, however, that for an outreach effort such as suicide prevention doing so can be very challenging. Some things cannot be measured, and your team might determine that it’s enough to assert, ”This is the right thing to do.” Also, the suicide prevention program may be part of a larger initiative, perhaps on depression education, and so it can be difficult to identify cause and effect.

• rates of suicide and suicide attempts
• rates of referrals to EAP
• rates of medical and psychiatric hospitalizations due to significant suicide attempts and/or acuity
• rates of absences and disability claims due to significant suicide attempts and/or acuity

Reporting the results of such evaluation can help maintain senior management support for the program.

Communication objectives
As part of the overall effort to mitigate modifiable risk factors and strengthen protective factors for suicide, “The Surgeon General’s Call to Action to Prevent Suicide” includes recommendations to build awareness. You might adopt these as your own core objectives:

• Promote awareness that many suicides are preventable; make facts about suicide and its risk factors and prevention approaches available to the population.
• Reduce the stigma associated with mental illness, substance abuse and suicidal behavior and with seeking help for such problems.
• Expand awareness of suicide prevention programs and mental and substance abuse disorder assessment and treatment.

• Promote the development of interpersonal and social competency, through training in stress management and coping skills to help individuals deal with problems.
• Promote listening and interpersonal skills to help individuals improve their relationships.

Key messages
To support the previously stated objectives of raising awareness, here are some key messages to include in your communications. Consistent and frequent dissemination will maximize the impact:

• Suicidal feelings are temporary.
• Treatment can make people feel better.
• It’s a sign of strength to ask for help.
• Take talk of suicide seriously, in a family member, friend or co-worker.
• Help is available:
• In emergency situations, contact a doctor, the nearest hospital emergency room or 911.
• For non emergencies, the EAP is available 24 hours, seven days a week via the toll-free telephone number, (XXX) XXX-XXXX.

Communication cautions
Some lists of warning signs for suicide have been created in an effort to identify and increase the referral of persons at risk. The warning signs are not exclusively risk factors for suicide, however, and may include behaviors common among distressed persons. If such lists are applied broadly, they may be counterproductive. In effect, overly inclusive screening lists may promote suicide as a possible solution to ordinary distress or suggest that suicidal thoughts and behaviors are normal responses to stress.

The Surgeon General emphasizes that efforts must be made to avoid normalizing, glorifying or dramatizing suicidal behavior, reporting how-to methods, or describing suicide as an understandable and typical solution to a traumatic or stressful life event. Inappropriate approaches could potentially increase the risk for suicidal behavior in vulnerable individuals.

The American Foundation for Suicide Prevention, American Association of Suicidology and Annenberg Public Policy Center have developed some specific recommendations about language to reduce the chance of contributing to suicide contagion:

• It is preferable to describe the deceased as "having died by suicide," rather than as "a suicide," or having "committed suicide." The latter two expressions reduce the person to the mode of death, or connote criminal or sinful behavior.
• Contrasting "suicide deaths" with "nonfatal attempts" is preferable to using terms such as "successful," "unsuccessful" or "failed."

General communication reminders
It’s also helpful to keep in mind some key communication principles as you design your plan:

• Communicate frequently — People need to hear messages many times before they adopt them. Therefore, consider embedding messages that relate to this suicide prevention initiative in other relevant communication campaigns. For example, “It’s a sign of strength to ask for help” is relevant whether the topic is suicide, depression, substance abuse or domestic violence.
• Be focused and consistent — Try to keep the communication focused on supporting the key messages rather than introducing additional concepts. Keep the language consistent.
• Know your audience — How can you best reach them? Do they prefer written or oral communications? Print or electronic? Live or video-based? What’s their functional reading level? Are there cultural issues or perspectives to consider? Do you anticipate special needs—for example, the anniversary of a co-worker’s suicide? Ideally, you would create a strategy for your general population, and then design specific outreach tactics for supervisors and other identified target audiences.
• Consider context — What else is going on in the company? Are significant changes underway or proposed—such as plant closings, a restructuring or layoffs? The risk of suicide and workplace violence escalates during such times.
• Try different approaches — As with all behavioral interventions, multidimensional interventions likely will have the best results, especially given the overlapping nature of risk and protective factors.
• Make a long-term commitment — Repeat interventions will reinforce the original prevention goals.

Tactics
With this strong foundation of commitment, data and clear objectives, as well as a grounding in communication principles, you now can devise tactics that support achievement of your objectives. Please review the “Tools” section, which describes the communication tools ValueOptions is making available to support your organization’s suicide prevention efforts.