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Exercise effectively treats depression and may decrease suicide attempts
A 2023 meta-analysis of randomized controlled trials (RCTs) found that supervised, group or non-group, moderate- or vigorous-intensity, aerobic or resistance exercises (excluding mind–body activities such as yoga) decreased depressive symptoms among participants with depression, with a number needed to treat of 2 and an effectiveness comparable to first-line treatments such as psychotherapy and medication. Another 2023 meta-analysis of RCTs found that exercise decreased suicide attempts among people with mental or physical illness.
Suicide prevention has been named a national priority and much work has been done to review existing evidence and identify gaps in how our nation’s mental health and health care systems address this public health challenge. A national task force that was part of the effort to update the national suicide prevention strategy reviewed research and best practices from the field and
concluded that suicide prevention could be improved in health care. The task force found three common characteristics among successful suicide prevention programs in health care settings. Health care staff in these organizations:
Believed that suicide can be prevented in the population they serve through improvements in service access and quality, and through systems of continuous improvement;
Created a culture that finds suicide unacceptable and sets and monitors ambitious goals to prevent suicide; and
Employed evidence-based clinical care practice, including standardized risk stratification, evidence-based interventions, and patient engagement approaches1.
The task force’s recommendations formed the foundation of the Zero Suicide Approach for health care organizations. The recommendations contained in this guide are based on those offered in the comprehensive Zero Suicide in Health and Behavioral Health Care Toolkit [http://zerosuicide.sprc.org/toolkit]. Here they have been adapted specifically for primary care organizations and clinicians who care for underserved populations.
The guide focuses on two core components:
1. Screening and assessment
2. Care management and referral processes
The final section contains some additional information on administrative and legal issues providers and leaders may find helpful to support integration of safer suicide care in practice. Many providers and clinical leaders erroneously assume if they discuss suicide with a patient they open up themselves to liability. Utilizing a patient safety approach, primary care organizations can
establish safer suicide care practices that deliver high quality care to patients and reduce risk to the organization.
In each section of this guide you will find:
Information summarized for providers, including some helpful provider communication tips.
A list of recommended trainings and resources to learn more.
Leadership actions organizations may wish to undertake to help providers reduce suicide in their organization’s
patient population, and
Relevant tools, templates and case studies.
This toolkit begins with a brief background on the impact of suicide and offers a case study illustrating how one federally qualified health center adopted a safer suicide care model.
Suicide rates have been rising during the past several years, but suicide is preventable.
There are many known risk factors for suicide, but the predictive utility of any single risk factor is low, requiring a focus on population-level rather than individual-level prevention.
There are proven processes for identifying suicide risk and intervening in health care, criminal justice, and education settings.
There is also a need for an enhanced data infrastructure to support suicide and self-harm surveillance systems.
Additional policy intervention is needed to scale and spread successful prevention approaches and to identify others. For example, policies should support removal of lethal means, increased funding for help lines and school-based programs, and integration of mental health care into routine health care.
Suicide rates have been rising during the past several years, but suicide is preventable.
There are many known risk factors for suicide, but the predictive utility of any single risk factor is low, requiring a focus on population-level rather than individual-level prevention.
There are proven processes for identifying suicide risk and intervening in health care, criminal justice, and education settings.
There is also a need for an enhanced data infrastructure to support suicide and self-harm surveillance systems.
Additional policy intervention is needed to scale and spread successful prevention approaches and to identify others. For example, policies should support removal of lethal means, increased funding for help lines and school-based programs, and integration of mental health care into routine health care.