How to Use Multiple, Complementary Approaches

If you are interested in more in-depth information, click on the links provided throughout this element.

Why and how people become suicidal, make a suicide attempt, or die by suicide is complex. Their behavior is influenced by multiple risk and protective factors that may come from themselves, their relationships, their community, and society at large. To have an impact on these multiple factors, consider using a range of strategies and approaches working together. The interaction between different approaches can have a greater impact than each approach by itself. The Centers for Disease Control and Prevention’s (CDC’s) Suicide Prevention Resource for Action and the Suicide Prevention Resource Center’s Best Practices Registry highlight evidence-informed approaches that you can use together.

When selecting your approaches (i.e., programs, policies, and practices), focus on the particular needs of the different groups you identified in your goals and objectives in the Planning element. Tailor your multiple approaches to the social, economic, cultural, and environmental context of the individuals and populations that are most significantly affected.

It is strongly recommended that you use suicide prevention programs, practices, and policies that have the best available evidence (also known as evidence-informed approaches). However, in some cases there aren’t scientifically proven approaches that address communities’ specific cultural needs. These communities can draw from their own cultures for alternate prevention approaches, tailoring them as needed to follow basic suicide prevention practices and safety guidelines. Or they can adapt evidence-informed approaches and tailor them to their needs. It is especially important to evaluate the outcomes of these approaches to make sure they are having a positive impact on suicidality or suicide risk or protective factors. See the Fit element for more information.

For maximum impact, it is recommended that communities also work to prevent other behaviors that share risk and protective factors with suicide, such as violence, adverse childhood experiences, and substance misuse. Coordinating with programs and services such as housing, employment, and child protective services can amplify the impact of suicide prevention in the community. Additionally, consider choosing approaches that support well-being across the lifespan. To learn more about shared risk and protective factors between suicide and other forms of violence, visit Connecting the Dots.

There are two key areas for achieving the Integration element:

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Ohio’s Allen County suicide prevention coalition was grappling with the loss of local veterans to suicide. They were seeing a high number of suicide deaths occurring at the same isolated locations at community reservoirs. Coalition members discussed what prevention activities were evidence-informed, feasible, and could directly address these suicide deaths. Then they worked with their City Parks Department to purchase and place permanent signage that promotes help-seeking and the Veteran’s Crisis Line at all five city reservoirs.

– Donna Dickman, Ohio Certified Prevention Specialist, Director of Development for Prevention Awareness Support Services