If you are interested in more in-depth information, click on the links provided throughout this key area.
Community context refers to the environment, structures, and situations that are a part of your community. Culture refers to the norms, traditions, and beliefs that your community embraces. Both directly influence community members’ day-to-day activities, expectations, and interactions. Context and culture should guide all efforts and actions in suicide prevention.
Only when you have taken the time to conduct community needs assessments, assess community readiness, and involve diverse populations are you prepared to fully incorporate community context and culture into your prevention efforts. A prevention approach that is a poor fit with your community context is not likely to succeed. Ensure that context and culture guide which prevention approaches you select. See Integration 1, Step 3: Consider community fit and feasibility. Context and culture should also guide how your group carries out approaches, evaluates activities, and makes decisions.
Once you have developed active engagement from diverse partners, help the group learn about the culture and the needs, challenges, strengths, and opportunities each partner sees in their communities. Do not assume that risk and protective factors related to suicide are the same for all parts of your community. For example, you may find that Latino men are the most likely to die by suicide, and that many of them believe seeking help for mental health is a sign of weakness. Addressing this belief would be crucial for preventing suicide in your community.
Learning about diverse populations requires effort and time, but it is a key part of strategic planning. It can range from holding community conversations to conducting formal community needs assessments. If you do not understand the diverse cultures and needs in your community before you choose suicide prevention approaches, they may not have much impact.
Your coalition can also set aside regular time during meetings to discuss what members notice in their settings, organizations, and regions related to the issue of suicide. These discussions can help your coalition note changes in community perceptions and trends related to suicide, stay aware of local suicide deaths, and be better prepared to reach out with ongoing support when needed. The discussions are also essential for ensuring that the voices of all community settings and populations are heard.
Consider using national and local news articles, research reports, data summaries, and press releases on prevention activities as tools to facilitate these discussions. You can use the following broad questions to gather feedback:
To find a list of evidence-informed suicide prevention approaches, look at CDC’s Suicide Prevention Resource for Action (Suicide Prevention Resource). For specific programs, look at SPRC’s Best Practices Registry. As you select your approaches, look at whether each program, policy, or practice is a good fit with your community context and culture. See Integration 1, Step 2: Review evidence-informed approaches and Integration 1, Step 3: Consider community fit and feasibility for details on selecting prevention approaches. Sometimes it will be clear whether an approach fits your community. Other times, an approach may have potential but needs changes to strengthen its use in your community. In the latter case, you will want to adapt the approach.
The adaptations that the approach needs will be unique to each program, policy, or practice. Start by exploring whether the authors of an established program or practice allow and/or encourage adaptations. If they do not, move on to another prevention approach.
If the authors allow adaptations, bring together the community partners who will be involved in the approach. Discuss with these partners what adaptations are needed and create a plan for incorporating the changes before putting the approach in place. For more advice on adapting prevention approaches, see Guidance for Culturally Adapting Gatekeeper Trainings and CDC’s VetoViolence: Select, Adapt, Evaluate.
While the use of scientifically proven, evidence-informed approaches is important in suicide prevention, it is also important to acknowledge approaches that have just been developed and tested locally. Your community subgroups may have culturally based practices, programs, or resources they can use to prevent suicide or address suicide risk and protective factors that are not represented in a “best practice registry” or CDC’s Suicide Prevention Resource.
Take time to learn about the locally developed practices, programs, and resources that can help reduce suicide risk and increase protective factors. For example, a group of middle-aged adult men may meet weekly to work on cars to donate to service members’ families. A tribal community may engage elders to teach youth their native language. While these two activities do not appear related to suicide prevention at face value, they increase social connectedness and community engagement, which evidence shows are key protective factors against suicide.
As you think about using locally developed approaches in your suicide prevention efforts, try to ensure that they follow best practices for safety in suicide prevention. For example, research has shown that large assemblies with a speaker can be harmful because individuals who are struggling may not be noticed. Small group settings provide a better opportunity for identifying and supporting these individuals. If safety guidelines are not being followed, determine how you can work with your local partners to reframe or adapt prevention approaches.
Safety guidance for suicide prevention activities that are often locally developed:
If you have additional questions about how to ensure safety in your suicide prevention efforts, reach out to your state suicide prevention contact(s) who can provide feedback and guidance.
To see whether existing cultural approaches are impacting suicide risk and protective factors, it is helpful to evaluate the effects they have on key populations. For example, if a local African American youth organization hosts rite of passage classes and ceremonies, work with them to evaluate the program’s impact on increasing problem-solving and conflict resolution skills, as well as improving dating relationships, which are known protective factors for suicide.
Culture and context should inform all prevention planning from selecting approaches to adapting and implementing them to evaluating and improving them over time. As you monitor the impact of your prevention approaches (see the Data and Planning elements), ask your work groups and coalition to reflect on how each subgroup’s culture and context plays a role in the approaches’ results.
For example, if your coalition is gathering participants to engage in a training but participants are not using the content they learn, could it be because the training content is calling for actions or activities that do not work in their culture or setting? Or could positive engagement in suicide-specific treatments be because peer support workers are providing strong care transition support that reflects your populations’ beliefs?
Ensure that you are incorporating questions about culture and context into your evaluation of prevention efforts. Also make sure you use the results to make improvements as needed that either (a) bring approaches better in line with local context and culture or (b) allow for different approaches to be used that are more reflective of the local environment. See CDC’s VetoViolence: Select, Adapt, Evaluate to learn more.
For additional information on monitoring and improving your prevention approaches and activities, visit Planning 3, Step 6: Monitor progress and outcomes over time and Planning 3, Step 7: Make changes to your plan over time.