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A Comprehensive Approach

Comprehensive, multi-strategy approaches, which are implemented across an array of settings and contexts and developed by/within local communities, are recommended. These community strategies and practices should be informed by current research evidence and should honour and build on local community knowledge, values and traditions. There is no such thing as a singular “one size-fits-all” approach to preventing youth suicide. Each youth, family, and community is unique and close attention must be paid to the particular social, cultural, political and historical context when designing and implementing youth suicide prevention strategies. This is important when working with individual clients or at the community level.

Having a visual framework or map that can capture the multiple, broad elements of a comprehensive youth suicide prevention strategy can assist practitioners recognize the breadth of this work, while also enabling them to locate themselves and their particular contributions within this larger view. For the purposes here, the work of youth suicide prevention is being envisioned as a series of strategies and programs that engage individuals and their social environments. Table 2 provides one example of how this work might be conceptualized at a community level. Note that the horizontal axis represents a continuum of prevention interventions from population-focused mental health promotion efforts to clinical interventions with individuals-at-known risk. A list of key target groups and settings is described along the vertical axis.

Table 2. Mapping a Community-Wide Approach to Youth Suicide Prevention highlights specific topic areas including some of the most promising youth suicide prevention strategies identified in the professional and empirical literature. 18 19 20 21

As you explore Table 2, be mindful of the fact that the language we use to describe suicide prevention activities is discrete and categorical - giving the false impression that this work is neat-and-tidy - which can sometimes get in the way of thinking about youth suicide prevention practice in a richer, more complex, and holistic way.

Several key ideas are worth emphasizing here:

    1. Broad-level population strategies, which are aimed at promoting youth resilience and strengthening their social environments, are an important aspect of any youth suicide prevention strategy.
    2. Increasing the capacity of individuals, families, schools and communities to detect potential suicide risk through high quality education and awareness efforts is a key aspect of youth suicide prevention work.
    3. Being familiar with effective clinical interventions for youth who are struggling with suicide ideation and/or who have already made a suicide attempt, which includes collaborating with family members and other care providers, is a key component of ethical and effective clinical practice.
    4. Knowing which strategies and approaches to employ following a youth death by suicide in a school or community is an important consideration for reducing risks for imitative suicidal behaviour and promoting healing and assisting after a suicide.
    5. Child and youth mental health practitioners and their community partners can make an ongoing commitment to enhancing and sustaining their local youth suicide prevention practices by engaging in a series of system-level support strategies. These include: ongoing professional development for clinical staff; leadership, planning and service coordination; multi-sectoral coalition-building; developing proactive policies and protocols; and setting goals, monitoring progress and incorporating new learning.