Policies around economic security, alcohol use, and safety restrictions have strongest potential for reducing suicide deaths
An analysis co-authored by NYU Silver School of Social Work Dean and Paulette Goddard Professor of Social Work Michael A. Lindsey determined which public policies most effectively prevent suicide deaths in the United States. These policies include limiting firearms and expanding access to health care, but also many economic and social policies that are not explicitly focused on mental health, according to the article published in the Annual Review of Public Health.
“Most of the policies that demonstrate evidence do not mention suicide and were not passed to prevent suicide. They are policies that are intended to address other issues—for instance, increasing minimum wage to promote economic security or reducing alcohol consumption—but they have spillover benefits in that they also prevent suicides,” said Jonathan Purtle, Associate Professor of Public Health Policy and Management at the NYU School of Global Public Health and the study’s lead author.
“This research highlights the importance of considering social determinants in suicide prevention,” said Dean Lindsey. “An individual’s mental well-being is influenced not only by clinical factors, but also by their environment, circumstances, and experiences.”
Policy activity climbs to address a growing need
Suicide is a leading cause of death in the U.S. and rates have increased over the past two decades. Public policies, including laws passed by elected officials and regulations adopted by public agencies, play an important role in reducing suicide deaths. While suicide is addressed by some federal policies, most public health policy authority is at the state level.
In their article in the Annual Review of Public Health, the researchers analyzed the number of state bills passed that mention suicide over the past two decades, as well as the volume of social media posts from state legislators on the topic—an indicator of policy priority. They found a dramatic increase in both, particularly beginning around 2017.
“Our analysis suggests that policymakers recognize that suicide is an issue of public health significance and are trying to address it, and there is bipartisan concern,” said Dr. Purtle.
Policies with the best potential to work
While many studies have looked at the impact of individual policies on suicide risk, until now, there was not an analysis that collectively examined the research to provide a deeper understanding of what policies are most effective.
To develop this analysis, Drs. Purtle, Lindsey, and their colleagues reviewed more than 100 studies and uncovered three categories of policies that research shows have the potential to prevent suicide:
Policies that limit access to lethal means (e.g., policies for safe firearm storage and waiting periods to purchase firearms, installing barriers on bridges)
Policies that increase access to mental health services (e.g., Medicaid expansion, laws requiring insurance to cover mental health care)
Policies that address underlying risk factors for suicide, including those that increase economic security (e.g., minimum wage laws, paid sick leave, unemployment benefits, supplemental nutrition program), prohibit discrimination (e.g., protecting sexual and gender identity in hate crime laws), and limit access to alcohol and tobacco
While policies in all three categories have some potential to reduce suicide deaths, the researchers found that policies to improve economic security, limit access to alcohol, and restrict access to lethal means have the strongest evidence of working.
“Access to alcohol and lethal means of harm, as well as poverty, are all known risk factors for suicide,” said Dean Lindsey. “Our research suggests that a great starting place for saving lives is to fund and enact public policies that target these three areas.”
In addition, while some of the most effective policies focus on improving well-being over the long term, others—including those related to firearms and restricting other lethal means—aim to make it more difficult to make quick decisions that can have fatal consequences.
“Suicide is often an impulsive act,” said Dr. Purtle. “Anything you can do to delay that impulsivity on average will be beneficial and will prevent suicide from a public health perspective.”
Amanda Mauri of the NYU School of Global Public Health and Katherine Keyes of the Columbia Mailman School of Public Health were additional authors of the study. The research is supported in part by the National Institute of Mental Health (R01MH131649).
This article is adapted from a press release by New York University.
Read more about the study’s findings on NYU’s website.