Implementing the national suicide prevention strategy: Time for action to flatten the curve.

Since 1999, the Office of the United States Surgeon General has identified suicide prevention as a national public health priority. The National Strategy on Suicide Prevention, coordinated by the public-private Action Alliance, was most recently updated in 2012. In early 2021, the Surgeon General's office released a Call to Action to fully implement the national strategy. Six core types of actions to prevent suicide include adopting a broad public health approach, addressing upstream factors including social determinants of health, reducing access to multiple forms of lethal means, adopting evidence-based care for persons at risk, enhancing crisis care and care transitions, and improving the quality and use of suicide-related data. From 1999 through 2018, suicide rates in the U.S. increased by approximately one-third, and suicide had become the tenth leading cause of death. While most recent national data indicate a small reduction in the suicide rate, decreases were not seen across all demographic groups. Population groups which may require special emphasis or outreach efforts include adolescents, working age adults, military veterans, and American Indians/Alaskan Natives. Increases in social isolation, mental distress, and economic hardship during the COVID-19 pandemic indicate clear needs to address the full spectrum of suicidal behavior. This will require a multisector and whole of government approach, using contemporary evidence-informed approaches and best practices as well as innovative methods including those based on predictive analytics.