Suicidal Ideations and Public Health Interventions Research Paper

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Introduction

A healthy population is a good sign of a healthy society. For its constant monitoring, maintenance, and improvement, countless healthcare professionals are conducting research and implementing various strategies and interventions. In this context, suicidal ideation represents one of the most significant concerns for society due to its scale and addressing complexity. Additionally, because of its statistical prevalence among children and adolescents, the topic of not-decreasing suicide rates draws more scholarly attention with each passing day. Consequently, this paper will first provide the general background on the ways of monitoring public health and determining the threats. Then, it will highlight the issue of suicidal ideations, emphasizing the strategies and interventions used in the healthcare field.

Leading Health Indicators

With the aim of maintaining and improving the well-being of the American people, the organization called Healthy People has devoted itself to establishing benchmarks and monitoring the progress of a scientifical approach to the matter. On a grand scale, Healthy People design a set of 10-year national plans and objectives spread over the vast areas of public health (ODPHP). The organization has operated for over three decades at the moment, having achieved substantial success in its activity (ODPHP). For example, they indicate the increase in life expectancy at birth with a simultaneous decrease in the death rates from strokes and coronary heart diseases (ODPHP). Nevertheless, there are still issues that demand attention and require a more individualized approach.

Consequently, in order to narrow the scope, the Healthy People organization developed a set of smaller objectives referred to as Leading Health Indicators (LHIs). These smaller objectives serve to highlight the high-priority health issues and ways of possible solutions available for them. LHIs gradually assess the population’s health, foster cooperation across different societal sectors, and call for action at community, state, and national levels in an attempt to further improve the people’s well-being.

Strategy for Selecting Health Indicators

The strategy of LHIs development in many ways mirrored the creation of the initiative itself – extensive inter-organizational collaboration. People responsible for Healthy People policies and actions work under the Healthy People 2020 Federal Interagency Workgroup. Its members mainly come from the U.S. Department of Health and Human Services (HHS), with other Federal departments involved. The workgroup uses the information it receives from inside the HHS department, the Institute of Medicine of the National Academy of Sciences, and the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention (ODPHP). In addition, to ensure that numerous HHS and other Federal Departments’ initiatives better align with their common goal, the workgroup considered key priorities and took council from the secretary and assistant secretary for health (ODPHP). Lastly, consideration was given to the National Prevention Strategy in accordance with the Affordable Care Act.

Target Population

In general, LHIs target the whole population of the U.S. In particular, every individual indicator might have features emphasizing a specific group inside the population that is more susceptible or stronger exposed to the given health issue. For instance, one of the LHIs is concerned with the general accessibility of healthcare services due to the high rates of people without insurance or without a primary care provider (20% and 25%, respectively) (ODPHP). Consequently, making medical insurance and routine medical care more accessible will have a substantial positive effect on the well-being of the American population. In contrast, the LHI of maternal, infant, and child health has a much more concrete target population. In order to secure a healthy future for society, this indicator emphasizes the well-being of mothers, infants, and children in the context of families and communities.

Data that Influenced Selection of Health Indicators

The Healthy People select and organize the LHIs adhering to a specific conceptual framework that evaluates the population’s health determinants and its health across all life stages. Regarding the former, these determinants represent social, economic, biological, and environmental factors – separately and in their interconnection – that can influence individuals and communities on their way to a healthy lifestyle (CDPH). Evaluation and control of health determinants allow Healthy People to monitor the health state and occurring disparities and adjust the LHIs accordingly. In the case of the latter, the way how health determinants and risk factors change over the course of life provides necessary feedback to the established LHIs, making the system more flexible and responsive. In addition, it provides information about the proper time and means for an effective intervention, which further increases the LHIs’ responsivity. The timely intervention is especially important in the case of mental diseases and suicidal ideations.

Evidence Indicating the Danger of Suicide for Youth

Suicide cases represent one of the biggest concerns for the healthy population. Firstly, contemporary research defines suicide as the leading cause of death across all population groups (approximately 800,000 deaths each year worldwide) (Cha et al., 2018). Secondly, suicidal thoughts and cases are the most frequent among the youth, which makes prevention even more critical for the sake of society’s future (Cha et al., 2018). Finally, suicidal ideation is preventable, usually being gone during adolescence after the successful intervention (Cha et al., 2018). In this context, these factors made the Healthy People workgroup define suicides and suicidal ideation as a part of the LHIs, categorizing them together with other mental health issues. Suicidal thoughts and behavior have their own epidemiology, mechanisms, and related treatments and intervention technologies. Consequently, they became the target of LHI, motivating and stimulating their development and improvement.

Strategies for Marketing a Population-Focused Intervention

Population-focused interventions provide a valuable asset in suicide prevention. Such kinds of interventions can have a substantial effect if implemented in healthcare but, unfortunately, are most of the time underused (Wolk et al., 2018). The strategy of implementation is generally subjected to the following factors: intervention characteristics, outer and inner community settings, characteristics of individuals implementing the strategy, and the implementation process (Wolk et al., 2018). Each of the mentioned domains has specific barriers and facilitators that have to be examined first before a strategy implementation can begin.

The strategies themselves can vary depending on the scope and means of implementation. For example, implementing an intervention in electronic health records would allow the transparency of screening results, ultimately simplifying the issue monitoring (Wolk et al., 2018). However, if the intervention is not adequately presented both to clinicians and patients, there is a danger of “stigmatizing youths by singling them out as at risk” (Wolk et al., 2018). Consequently, a proper marketing campaign and staff education and training will be needed to inform the population and avoid ambiguities.

Specific Strategies to Engage the Target Population

As with any type of target population, young people require specific approaches in order to have the desired effect. Since the majority of children and young people attend various educational facilities, school-based interventions present the vanguard of suicidal interventions. Unfortunately, not all such interventions can be considered successful in their goals (Silk et al., 2017). According to Kutcher et al. (2017), the gatekeeper (SafeTALK) training with the following access to mental healthcare provision for youth identified at risk showed promising results, along with the Good Behavior Game practice. Apart from that, school-based interventions’ positive results in decreasing suicide rates proved to be difficult to identify (Kutcher et al., 2017). Another specific strategy to approach young people is a full-scale community universal intervention. For instance, Kutcher et al. (2017) studied a Signs of Suicide (SOS) intervention program that displayed a 50% success rate in decreasing suicidal ideation and attempts. For both types of intervention, the collective compared the available research to justify or refute their effectiveness.

Evidence-Based Practice Rationale

The SafeTALK program is a suicide intervention strategy that aims to increase awareness among community members of the signs of risk in potentially endangered individuals. The literature review on the subject yielded the only positive program effect to be the willingness of educated participants to help people with suicidal ideation (Kutcher et al., 2017). Nevertheless, the program’s impact on actual suicidal prevention was confirmed to lack sufficient evidence, which leaves the program’s effectiveness unclear. The Good Behavior Game had a much more thorough knowledge background than the SafeTALK, showing positive results in reducing a general deviating behavior among children and young people (Kutcher et al., 2017). However, its effect can be considered too generalized for the chosen topic since suicidal ideation is only one of the many other deviating behaviors displayed by the youth. Finally, the SOS program that was labeled as “promising” in the reviewed literature managed to showcase only the relative between-group difference. In addition, there is a possibility that the literature is biased (Kutcher et al., 2017). Consequently, none of the popular suicide intervention programs is able to provide a definitive solution to the problem.

Plan Evaluation

With all the information presented above, Healthy People’s goals in addressing the suicidal issue prove to be totally justified. In the LHI’s inner structure, the concern about suicides is put in the first place, shortly followed by suicide among adolescents. According to ODPHP, the emphasis is put on suicidal ideation’s preventive screening, which can be considered the right decision, especially in the light of intervention’s inefficiency in reducing suicide attempts and fatal outcomes.

Conclusion

Population health and well-being will always present a great amount of concern for the healthcare field. Numerous federal and associated organizations, such as Healthy People, conduct research, identify significant issues, and constantly work on securing a safe and healthy future for society. As one of the measures for flexibility and responsivity of the general goals, Healthy People developed LHIs that continuously update and target the sharp edges of public health. In this context, the topic of suicide ideation (especially among the younger population) requires attention amidst the possible mental health issues. Despite the specific treatment and various intervention strategies, the issue remains unresolved, presenting a threat to societal well-being. While the research on the interventions’ improvement is being conducted, Healthy People emphasize preemptive screening for the ideation in order to prevent as many worst outcomes as possible.

References

(n.d.). California Department of Public Health (CDPH). Web.

Cha, C. B., Franz, P. J., M. Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2018). Journal of Child Psychology and psychiatry, 59(4), 460-482. Web.

Kutcher, S., Wei, Y., & Behzadi, P. (2017). The Canadian Journal of Psychiatry, 62(6), 381-387. Web.

Leading Health Indicators. (n.d.). Office of Disease Prevention and Health Promotion (ODPHP). Web.

Silk, K. J., Perrault, E. K., Nazione, S. A., Pace, K., & Collins-Eaglin, J. (2017). Journal of health communication, 22(2), 135-142. Web.

Wolk, C. B., Van Pelt, A. E., Jager-Hyman, S., Ahmedani, B. K., Zeber, J. E., Fein, J. A.,… & Beidas, R. S. (2018). Stakeholder perspectives on implementing a firearm safety intervention in pediatric primary care as a universal suicide prevention strategy: a qualitative study. JAMA network open, 1(7).

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