Suicide Prevention Research: Focusing on Hard to Reach Populations

Statistics consistently show that men, especially those of working age, are at a higher risk for suicide. Additionally, they are less likely to seek traditional forms of help.

For over two decades, I have dedicated a significant portion of my research to the field of suicide prevention. In particular, my work has revolved around adults and emerging adults, with a significant emphasis on partnering with male-dominated workplaces and studying suicide prevention among men, a traditionally hard to reach group.

Why the focus on men? Statistics consistently show that men, especially those of working age, are at a higher risk for suicide. Additionally, they are less likely to seek traditional forms of help. Men often resort to more lethal means when attempting suicide, such as firearms, leaving little opportunity for intervention or encouragement to seek support. To address this urgent issue, we must prioritize primary prevention and implement strategies earlier in the process of help-seeking.

One of the notable projects I have been involved in is the evaluation of Man Therapy, which led to several multi-year grant funded projects such as Man Therapy Michigan (MTMI) and Man Therapy Washington County (MTWC in Rhode Island). Through research, we have discovered significant benefits of Man Therapy including its effective use of anonymous online screening and referrals to community resources to reduce depression and increase help-seeking. In a CDC-funded study, I found that men who participated in Man Therapy reported fewer days of poor mental health, improved social support, and increased motivation for treatment. Notably, compared to the control group in this study, men who used Man Therapy were significantly more likely to seek formal help after using the website.

To make a real and lasting impact, my research centers on fostering community partnerships. Through collaborations with nearly 600 leaders and organizations in various communities, we aim to promote a combination of high-tech and high-touch approaches to men’s suicide prevention. By providing real-time data on the utilization of the Man Therapy website following specific events, we gain valuable insights into its efficacy and usage patterns.

A related project, focused more broadly on workplace mental health, but including aspects focused on reaching working-aged men is research on the Interactive Screening Program (ISP), created by American Foundation for Suicide Prevention. Our preliminary findings from 21 workplaces, encompassing over 8,000 ISP cases, reveal the potential of ISP in reaching high-risk employees who were previously not engaged in any mental health treatment. Furthermore, our research has shown that different online counseling techniques work differently for various employee populations. For example, in healthcare settings, the use of asking specific questions to the client was successful in encouraging mental health help-seeking behaviors; whereas with law enforcement we found that using confrontation in counseling was significant in helping to reduce ambivalence about seeking mental health services.

A third project I am involved with focused on workplace suicide prevention is the development and dissemination of the National Guidelines for Workplace Suicide Prevention. By analyzing data from the Centers for Disease Control and Prevention (CDC) on suicide death rates within various industries and occupations, we have observed that male-dominated workplaces, including construction, oil and gas, manufacturing, and law enforcement, experience statistically higher suicide death rates than the national average. Some of these industries have taken proactive measures to prevention suicide, in addition to addressing related behavioral health challenges among their workforce including opioid use disorder. A number of construction companies, in addition to other high-risk workplaces are adopting the guidelines as part of their culture and working to move efforts more upstream to prevent suicide among workers.

Given the systemic problems related to access, affordability, and effectiveness of care throughout our country’s mental health system, it is critical that we continue to move our suicide prevention approaches further upstream. Primary prevention initiatives, such as those targeting male-dominated workplaces, can play a vital role in saving lives by addressing the root causes and providing the necessary support and resources. By implementing evidence-based strategies, fostering community partnerships, and continuously evaluating and refining our interventions, we can make a significant impact in preventing suicide and promoting mental health and well-being.

In conclusion, suicide prevention research focused on prevention and early intervention among high-risk groups such as men and workers in male-dominated workplaces is crucial to make a significant decrease in the overall suicide death rate. Through initiatives like Man Therapy, Workplace Suicide Prevention National Guidelines, community partnerships, and workplace screening programs such as the ISP, we can engage hard to reach adults, including men and work in partnership to reduce risk factors while promoting good mental health. By adopting a comprehensive and multifaceted approach, we can save lives and contribute to a society that prioritizes mental well-being and support for all.