As the world marks World Suicide Prevention Day on September 10, this year’s theme, "Changing the Narrative on Suicide," takes center stage, with a call to action: Start the Conversation. Reflecting this theme, The Lancet Public Health has released a six-paper series, proposing a fresh approach to suicide prevention. The series emphasizes the need for a public health approach to address suicide, pushing for suicide prevention to be a central focus of policy actions worldwide.

Why a Public Health Approach?

Suicide is a leading global concern, with over 700,000 people dying by suicide each year. For individuals aged 15–29, suicide ranks as the fourth leading cause of death. Yet, suicide is preventable, making each death a tragedy that could have been averted.

Globally, suicide rates have seen a modest decline of 10% between 2013 and 2019, but not all regions have experienced this improvement. Alarmingly, suicide rates have increased in the Americas. As we approach the 2030 deadline for the Sustainable Development Goals (SDGs), which include reducing suicide mortality by one third, it's clear that efforts must be accelerated to meet this target.

Risk Factors and Social Determinants

Suicide prevention must begin with addressing its root causes. Risk factors for suicide range from family history, mental health disorders, and substance abuse, to external pressures such as stressful life events. However, these individual risks are often compounded by larger social and commercial determinants, including economic policies, societal values, and the influence of industries such as alcohol and firearms.

For instance, macroeconomic policies that lead to financial hardship, layoffs, or reduced wages can trigger life-altering stress. These broader societal forces act as upstream factors, creating a distribution of risk across populations. To truly make an impact, interventions must address these population-level determinants, shifting the overall risk towards a safer baseline and preventing individuals from reaching a crisis point.

A Population-Level Strategy

The proposed public health approach aims to tackle these determinants head-on. In the third paper of the series, Mark Sinyor and colleagues discuss how economic factors—particularly during periods of austerity or downturn—can be mitigated through policies like well-being budgets or retraining programs. Efforts such as establishing liveable minimum wages have been linked to reductions in suicide rates, particularly in the U.S.

The series also highlights the importance of addressing commercial determinants. For example, Jane Pirkis and her team emphasize targeting industries that contribute to risk factors, such as alcohol use. Some factors, however, require more focused interventions specific to suicide prevention. This includes regulations for responsible media reporting on suicide, awareness campaigns to direct individuals toward health resources, support for those bereaved by suicide, and restrictions on access to means of suicide.

Shifting Responsibility Across Government

At the heart of this new approach is the idea of changing the narrative—from one that focuses solely on individual intervention to one that considers the entire population's well-being. This shift demands a policy reset, in which responsibility for suicide prevention is expanded beyond health departments to encompass all parts of government.

The series urges governments to adopt a suicide prevention in all policies approach. This would ensure that each department is held accountable for its influence on the social and commercial factors that drive suicide risk. Whether it's housing, employment, or health policies, all areas of governance must consider how their actions affect suicide prevention efforts.

Untapped Potential for Progress

By addressing the social and commercial determinants of suicide, there is untapped potential to significantly accelerate global progress in preventing suicide. With a collective, multi-sectoral effort, governments can create a future where suicide is not only less common but preventable through proactive, population-wide measures.

As the global community continues to battle the mental health crisis, this new public health approach to suicide prevention could be the breakthrough needed to save lives and bring hope to millions.