Tennessee Strategy for Suicide Prevention

The Tennessee Strategy for Suicide Prevention builds upon the goals published in “National Strategy for Suicide Prevention: Goals and Objectives for Action” printed by the Department of Health and Human Services, United States Public Health Service, Rockville, MD, in 2001, and revised in 2012.

TSPN’s response to the National Strategy document was drafted in the fall of 2002 and revised in 2004, 2006, and 2007. Following the revision of the National Strategy in 2012, a new version of the Tennessee Strategy was approved by TSPN’s Advisory Council on 2013, 2019, 2022, and 2023.

1. Develop broad-based support for suicide prevention.

Tennessee Response:

A. Form and sustain public-private partnerships with the widest variety possible of community partners in suicide prevention activities, up to and including state departments and agencies.

• TSPN staff and members will recruit the participation of organizations and individuals who can contribute to suicide prevention activities.
• TSPN staff and members will engage these organizations and individuals in regional TSPN events, meetings, and other volunteer opportunities.

B. Continue to engage state, county, and city government in suicide prevention efforts including, but not limited to, the annual Suicide Prevention Awareness Month effort.

• Regional members will contact governmental officials regarding the proclamation effort and secure their participation.
• Regional members will work with county/city governments to develop plans for suicide prevention efforts to include community and more targeted efforts including training opportunities (employers, faith-based entities, etc.).

C. Advocate and educate the General Assembly and state departments on efforts such as improved access to community-based mental health and substance abuse services and legislation on providers’ suicide care competency.

• The TSPN central office will organize regular meetings of the Intra-State Departmental Group.
• The Executive Director will identify and fill vacancies within the Intra-State Departmental Group.
• The TSPN central office will release an annual Status of Suicide in Tennessee report, providing copies to members of the General Assembly.
• The TSPN central office will invite members of the General Assembly from each region to regional meetings and events.
• The Advocacy Committee will develop advocacy priorities yearly and/or collaborate with other community organizations for advocacy events such as "Day on the Hill" events.

D. Educate stakeholders about state budgets and legislation that could affect mental health and substance abuse services and encourage an active role in advocating for suicide prevention efforts.

E. Coordinate with other suicide prevention organizations in Tennessee towards more unified efforts of suicide prevention.

• The Executive Director will work with other suicide prevention entities on coordinating suicide prevention efforts throughout the state.

F. Coordinate with community stakeholders to provide trainings, awareness events, and materials throughout all regions of Tennessee.

2. Promote awareness that suicide is a public health problem that can be preventable.

Tennessee Response:

A. Encourage the cooperation of alliances to publicize suicide prevention services empowering every individual and organization to play a role in suicide prevention.

• TSPN will identify and approach entities (such as workplaces, schools, faith communities, county government, and civic groups) within each region annually for suicide prevention outreach and education on their role in suicide prevention.
• TSPN will engage people with lived experience in all aspects of suicide prevention.
• TSPN will create an annual strategic plan outlining tasks associated with engaging all entities playing a role in suicide prevention.

B. Use effective communications to engage diverse sectors in suicide prevention.

• TSPN staff will disseminate information on current apps and social media platforms for promoting connectedness and raising awareness.
• TSPN staff will update and utilize the website with new and current suicide prevention resources to share with the people of Tennessee.
• TSPN staff and members will distribute the resource directory to community stakeholders (legislators, first responders, educators, faith community, etc.) and the public.
• TSPN staff and members will conduct statewide or regional conferences and events to raise public awareness for suicide prevention.
• TSPN staff and members will participate in community stakeholder meetings and share suicide prevention information.

C. Broaden perceptions of suicide, who is affected, and the many factors that can affect suicide risk.

• TSPN staff and members will conduct various suicide prevention, intervention, and postvention trainings across Tennessee.

3. Increase knowledge of the factors that offer protection from suicidal behaviors and that promote wellness and recovery.

Tennessee Response:

A. Collaborate with organizations to promote suicide prevention and the use of mental health and substance abuse services and reduce stigma.

B. Produce and/or promote public service messages for television, radio, the TSPN website, and various social media platforms to reduce the stigma associated with mental health and substance use disorders while promoting the concept of recovery.

C. Offer training that includes information on suicide risk and protective factors to groups and individuals who work with at-risk persons.

• TSPN staff and members will offer trainings to gatekeepers and the community at large including information on risk and protective factors.

D. Encourage strengthening protective factors and reducing risk factors in communities across Tennessee.

• TSPN staff and members will support organizations that increase protective factors and reduce risk factors such as providing educational or programmatic opportunities for strengthening household financial security and house stabilization.

E. Partner with community organizations to promote strategies to prevent and mitigate Adverse Childhood Experiences (ACEs) and promote resiliency in adults and youth who have experienced trauma.

• TSPN staff and members will educate communities and stakeholders on the effect of toxic stress, trauma, and ACEs on youth and how this relates to suicide risk.

4. Promote responsible media reporting of suicide, accurate portrayals of suicide and mental illnesses in the news and entertainment industry, and the safety of online content related to suicide.

Tennessee Response:

A. Monitor references to suicide in locally originating television, radio, news media, and online content, in coordination with the national suicide prevention community, to promote better and more accurate depictions of suicide and mental illness.

• TSPN staff and members will provide ongoing feedback and/or guidance to media outlets regarding their coverage of suicide.
• TSPN staff and members will recognize portrayals that observe recommended guidelines in the depiction of suicide and mental illness.

B. Promote guidelines for responsible coverage of suicide and mental illness to journalism and mass communication schools and to news agencies, local elected officials, and state leadership.

• TSPN staff and members will contact regional media outlets and journalism schools to promote the American Association of Suicidology/CDC Media Guidelines.
• TSPN staff will maintain links to the American Association of Suicidology/CDC Media Guidelines on the TSPN website.
• TSPN staff and members will promote the guidelines via the TSPN e-newsletter and social media platforms.

C. Promote guidelines on the safety of online content for new and emerging communication technologies and applications.

• TSPN staff and members will educate media content providers about the American Association of Suicidology/CDC Media Guidelines.
• TSPN staff and members will provide information on how to report suicidal behavior through social media platforms.

5. Support the development, monitoring, and implementation of effective programs that promote suicide prevention and general wellness.

Tennessee Response:

A. Maintain a list of existing educational programs addressing mental health and/or suicide prevention for younger and older adults and other high-risk populations, updating it as needed.

B. Serve as a resource for agencies that work with high-risk populations, providing suicide prevention education and links to other agencies that promote mental wellness

C. Work with professionals who work with children, youth, and young adults to implement Jared’s Law and other related legislation, helping to develop policies, procedures, and protocols in suicide prevention, intervention, and postvention.  

D. Encourage suicide prevention training as part of professional licensure requirements under the Ken and Madge Tullis Suicide Prevention Act.

E. Collaborate with Tennessee Department of Health to receive and distribute ESSENCE Alerts to appropriate stakeholders across the state.

F. Develop and maintain ESSENCE Rapid Response Plans in collaboration with the Tennessee Department of Health and other stakeholders.

G. Encourage partnership or development of peer norm programs that support the development of positive connections with peers and encourage help-seeking behavior.

H. Collaborate in community engagement activities that bring together members of the community in promoting suicide prevention and/or general wellness such as a walking program or community garden.

6. Promote efforts to reduce access to lethal means of suicide and methods of self-harm among individuals with identified suicide risk.

Tennessee Response:

A. Encourage and educate behavioral health and health care providers on how and when to assess patients’ access to lethal means.

• TSPN staff and members will provide presentations on safe storage to health care providers in each region
• TSPN staff and members will promote the Suicide Prevention Resource Centers’ Counseling on Access to Lethal Means (CALM) free online training curriculum in all suicide prevention trainings.
• TSPN staff will promote CALM training on TSPN website and social media platforms.

B. Partner with firearm dealers and gun owners to incorporate suicide awareness as a basic tenet of firearm safety and responsible firearm ownership.

• TSPN staff and members will promote firearm safety recommendations, with an emphasis on suicide prevention, to firearm retailers and firing ranges.
• TSPN staff and members will conduct outreach to firearm retailers and firing ranges to ascertain if provided materials are being displayed/used.

C. Encourage and distribute educational materials on lethal means and safe storage practices, promoting these to health care settings, caregivers, and schools through the TSPN newsletter, website, social media platforms, and/or exhibits.

• TSPN staff and members will partner with local drug prevention coalitions, law enforcement agencies, and civic organizations to develop and/or maintain existing educational materials to make people aware of safe ways of storing, dispensing, and disposing of medications.

D. Develop, maintain, and distribute literature on gun safety and how to reduce access to lethal means in the home.

7. Encourage effective clinical and professional practices regarding suicide prevention for community and clinical service providers.

Tennessee Response:

A. Promote crisis intervention, suicide prevention training, and collaborative suicide risk management for teachers, police officers, first responders, and other gatekeepers who have a role in the prevention of suicide and related behaviors.

• TSPN staff and members will provide suicide prevention training and information on crisis intervention and suicide risk management to the above groups.

B. Provide and/or promote training to mental health and substance abuse providers on the recognition, assessment, and/or management of suicide-risk behavior and promote effective clinical care for people with suicide risk.

C. Promote the adoption of core suicide prevention training guidelines by all behavioral health and health care professionals, including those in graduate and continuing education and persons seeking credentialing and accreditation.

• TSPN staff and members will support and provide suicide prevention trainings for graduate schools or continuing education programs.

D. Encourage crisis centers, faith communities, community counseling centers, and community helpers throughout the state to implement effective training programs for family members of those at risk.

• TSPN staff and members will provide suicide prevention training to clients and family members served by crisis or counseling centers, church ministries, and/or other community agencies.

E. Encourage emergency departments and other provider/service agencies to refer persons treated for trauma, sexual assault, physical abuse, or domestic violence for mental health services.

8. Enhance crisis care and care transitions.

Tennessee Response:

A. Promote the development and use of statewide or regional crisis service hubs with the ability to track wait-list patients, access appointments for outpatient scheduling, and deploy the closest mobile crisis team.

B. Encourage the use of the mobile crisis teams in supporting continuity of care by scheduling outpatient follow-up appointments, utilize warm hand-off to engage the person at risk to treatment services and caring contacts that support continued care.

C. Encourage the utilization of crisis receiving and stabilization units as an alternative resource if the patient does not require inpatient care.

D. Promote the National Suicide Prevention Lifeline [988], statewide crisis hotline (1-855-CRISIS-1), Crisis Text Line (Text “TN” to 741741), and all local crisis centers in Tennessee which are part of the statewide crisis intervention infrastructure.

• TSPN and members will promote the above resources via regional newspapers, local television stations, exhibits, social media, state department websites, and other avenues.
• TSPN staff will publish this information on the TSPN website and in regional suicide prevention directories, all TSPN brochures, business cards, and various literature.
• TSPN staff and members will develop a state media plan to promote these numbers to the public via the media outlets outlined above.

E. Support the utilization and implementation of the national 988 number including coordination in contingency plans for meeting periods of increased demands.

9. Promote the screening, assessment, and treatment of people at risk for suicide as a core component of health care services.

Tennessee Response:

A. Promote the adoption of “zero suicides” as an aspirational goal by behavioral health and health care systems.

B. Encourage the implementation of guidelines for the screening and assessment of suicide risk and continuity of care for people at suicide risk in all behavioral health, health care, and substance abuse treatment settings.

• TSPN staff and members will provide training on the Columbia Suicide Severity Rating Scale to behavioral health, health care, and substance abuse treatment settings.

C. Encourage behavioral health and health care delivery systems to incorporate suicide prevention and appropriate responses to suicide attempts as indicators of continuous quality improvement efforts.

• TSPN staff and members will provide copies of the “After an Attempt” brochures to emergency departments.

D. Establish and/or promote links, collaboration, and coordination of services between providers of mental health and substance abuse services, community-based and/or peer support programs, health care systems, local crisis centers, and the families of suicidal individuals to promote a comprehensive and seamless network of care for people at risk for suicide.

• TSPN staff and members will establish links with the entities listed above and encourage representatives of these groups to attend TSPN regional meetings.

E. Establish and/or promote collaboration between services providers, peer support programs, trusted organizations, persons with lived experience, and the families of underserved groups to build a comprehensive care network.

• TSPN staff and members will establish links with the entities listed above and encourage representatives of these groups to attend TSPN regional meetings.
• TSPN staff and members will create programs utilizing the established network to reach and provide resources to underserved population.

10. Promote and implement effective clinical and professional practices for screening, assessing, and treating those identified as being at-risk for suicidal behaviors.

Tennessee Response:

A.   Promote the use of effective clinical and evidence-based practices around screening, assessment, and treatment with behavioral health and substance abuse providers.

• TSPN staff and members will encourage the implementation of evidence-based practices in policy and procedure.
• TSPN staff and members will provide training for behavioral health and substance abuse providers as needed.

B.   When applicable, promote new scientific, evidence-based research to behavioral health and substance abuse providers.

• TSPN staff and members will share information on emerging clinical practices with behavioral health and substance abuse providers.

11. Provide care and support to individuals affected by suicide deaths and attempts to promote healing and implement community strategies to help prevent further suicides.

Tennessee Response:

A. Create and/or assist in the development of protocols for postvention response following suicide deaths including strategies for potentially traumatized survivors.

B. Promote the availability of postvention services by TSPN and others to the public and institutions that may require such services, including schools, colleges, and businesses.

C. Encourage the development of support groups for survivors of suicide loss and survivors of suicide attempts and engage the support of these groups by community partners.

• TSPN staff will promote available support groups in printed materials, on the TSPN website, and through social media.
• TSPN staff and members will distribute information promoting support groups to community stakeholders, including first responders, educators, faith communities, and funeral homes. 

D. Adopt, disseminate, and implement guidelines for communities to prevent and respond effectively to suicide (s) and/or attempts within their cultural context.

• TSPN staff and members will provide the TSPN Postvention Guide to agencies affected by suicide.
• TSPN staff and members will maintain the TSPN Postvention Guide on the TSPN website and promote its availability through correspondence with community stakeholders, TSPN publications, and social media.

E. Promote appropriate postvention response to behavioral health, health care providers, first responders, and others affected by the suicide death of a patient.

12. Improve the quality, timeliness, and use of suicide-related data.

Tennessee Response:

A. Increase access to near real-time data related to suicide.

• TSPN staff will work with hospitals, law enforcement, emergency services, state departments, medical examiner’s offices, and other agencies to collect regional and statewide suicide-related data.
• TSPN staff will collect suicide-related data from new real-time sources as they become available.

B. Improve the quality of data on causes of death.

• TSPN staff and members will encourage and support the improvement of data collection of suicide-related data from hospitals, law enforcement, emergency services, state departments, medical examiner’s offices, and other agencies.

C. Expand the accessibility and use of existing federal data systems that include data on suicide attempts and ideation.

• TSPN staff and members will use federal data on suicide attempts and ideation as resources become available.

D. Improve coordination and sharing of suicide-related data across the federal, state, and local levels.

• TSPN staff will participate in and collaborate with various suicide data collection entities across the state including but not limited to Tennessee Violent Death Reporting Committee, Tennessee Department of Health Suicide Prevention stakeholders, Tennessee Department of Mental Health and Substance Abuse Services Suicide Prevention Consortium, and county and statewide Child Fatality Review Boards.
• TSPN staff and members will collaborate with Tennessee Department of Health, the Tennessee Department of Mental Health and Substance Abuse Services, and other entities to share near real-time data at the state and regional levels.
• TSPN staff will collect and share suicide related data from crisis response organizations such as the National Suicide Prevention Lifeline and Crisis Text Lines.

E. Use multiple data sources to identify groups at risk and to inform action.

• TSPN staff will review and report on suicide-related data annually.
• TSPN staff and the Advisory Council will support the creation of task forces to review and report on suicide-related data.
• TSPN staff and members will collaborate with the Tennessee Department of Health, The Tennessee Department of Mental Health and Substance Abuse Services, and other entities to develop targeted prevention efforts at state and regional levels.
• TSPN staff and members will collaborate with the Tennessee Department of Health to receive and distribute ESSENCE alerts to appropriate stakeholders across the state.
• TSPN staff and members will develop and maintain ESSENCE Rapid Response Plans in collaboration with the Tennessee Department of Health and other stakeholders.

13. Promote and support research on suicide and suicide prevention.

Tennessee Response:

A.   Share global, national, and state-level research on existing and emerging suicide-related research and serve as a resource for up-to-date suicide and suicide prevention information.

• TSPN staff and members will disseminate information on evidence-based suicide prevention programs and interventions via training sessions, workshops, the TSPN website, and social media.

B.   Dedicate resources to the development, implementation and evaluation of the interventions aimed at preventing suicidal behaviors.

• TSPN staff and members will collaborate with various entities to identify and secure support for new research, resources, and/or program implementation.

14. Evaluate the impact and effectiveness of suicide prevention interventions and systems and synthesize and disseminate findings.

Tennessee Response:

A. Disseminate information about effective suicide prevention programs and encourage their implementation across the state.

• When available, TSPN staff will promote emerging suicide prevention programs or curricula through social media and/or print publications.

B. Encourage and promote evaluations of suicide prevention programs in Tennessee, including those originating within TSPN and those of other agencies.

• TSPN staff will consult with regional mental health and suicide prevention agencies within Tennessee at least once a year regarding current evaluation projects.

C. Review the impact and effectiveness of the Tennessee Strategy for Suicide Prevention.

• The Strategies/Outcomes/Evaluations Committee will conduct an evaluation of the effectiveness of the Tennessee Strategy for Suicide Prevention, including recommendations for better implementation or amendment of the document itself.
• The Strategies/Outcomes/Evaluations Committee will annually review the work done by TSPN related to the Tennessee Strategy for Suicide Prevention and suggest amendments/recommendation for implementation.