Suicide prevention has evolved from single interventions to comprehensive, evidence-based strategies. Here’s what the latest research reveals about what actually works and what doesn’t.
What Works: The Evidence-Based Foundation
Safety Planning Replaces Outdated Approaches
The biggest shift in suicide prevention is the move from “no-suicide contracts” to collaborative safety planning. Research shows no-suicide contracts lack efficacy, while safety planning actually saves lives. Safety planning involves individuals identifying their warning signs, coping strategies, support people, and ways to restrict access to lethal means. This approach empowers individuals rather than simply extracting promises.
Proven Therapies
Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) demonstrate significant reductions in both suicidal ideation and actual attempts compared to standard treatment. Lithium continues to reduce suicide rates in patients with mood disorders. Ketamine shows promise for rapidly reducing suicidal ideation, though its effect on actual attempts needs more research.
Digital Innovation: Promise with Limitations
Electronic health record algorithms and smartphone monitoring can identify high-risk individuals and achieve small, short-term reductions in suicidal thoughts. However, current research shows these digital tools don’t effectively reduce actual suicide attempts or deaths.
The main challenge isn’t identifying risk but rather having proven interventions ready for those identified as high-risk. Patient engagement tools can augment this process by facilitating connection and follow-up care, but ultimately effective suicide prevention depends on human action and clinical response, not just technological identification. Digital tools work best as supplements to, not replacements for, established interventions delivered by trained professionals.
The Systems Approach
Effective prevention requires collaboration across healthcare, communities, and policy levels. The U.S. National Strategy emphasizes addressing social determinants like economic instability and healthcare access alongside clinical interventions.
Bottom Line
Suicide prevention works through layered approaches combining:
- Safety planning interventions
- Evidence-based psychotherapies (CBT, DBT)
- Means restriction counseling
- Brief interventions with follow-up care
- System-level strategies
The science is clear: when we implement evidence-based suicide prevention strategies systematically, we prevent deaths. No single intervention is sufficient, but comprehensive approaches save lives. The challenge now is translating this research into widespread practice and ensuring these proven strategies reach everyone who needs them. The path forward requires sustained commitment to both clinical best practices and the systems changes needed to make life-saving interventions accessible to all.
Crisis support is available 24/7 at 988 (call, text, or chat at 988lifeline.org).
