David Satcher, M.D., PH.D.
Assistant Secretary for Health and Surgeon General
Office of Public Health and Science

Remarks at the Release of 
The Surgeon General's Call To Action
To Prevent Suicide, 1999

Old Executive Office Building,
Washington, DC

  July 28, 1999

[This text is the basis for the Assistant Secretary for Health and Surgeon General's oral remarks. It should be used with the understanding that some material may be added or omitted during presentation.]

Thank you, Mrs. Gore, for having us here today. It is another example of the heartfelt leadership which for many years now you have brought to issues related to mental health. Thanks also to Senator Reid, Congressman Lewis, Doris Smith, Christopher Martin, and all of our friends present today.

After hearing the powerful and moving remarks from the people gathered here this morning, I don’t think I should have to convince anyone that suicide is a serious public health problem. Not only that, but it is reaching epidemic proportions in some groups. It is the eighth leading cause of death in the U.S. In recent years Americans have been very concerned about the number of homicides being committed across the country, but it surprises most people to learn that for every two homicides that take place in the U.S., there are three suicides committed. And suicides and homicides are often related, as was the case in Littleton, Colorado.

The Surgeon General’s Call to Action to Prevent Suicide is the product of an effort that has brought the best science together with the best experience on the subject of suicide prevention. We held a conference in Reno last year with researchers, clinicians, survivors and advocates to lay the foundation for a national suicide prevention strategy. Since then, we have been working hard to achieve this goal. There were more than 80 recommendations put forward at that conference.

In the course of reviewing those recommendations, we quickly realized that they could be refined or reduced to 15 essential major recommendations which, if implemented promptly, would greatly help to reduce the number of suicides as well as suicidal behavior. Given that the country is facing an average of nearly 85 suicides and about 2,000 attempts per day, we felt that it was important that we get these recommendations to the public as soon as possible, while continuing to work on a more comprehensive national strategy.

The 15 recommendations revolve around three principles—Awareness, Intervention, and Methodology—whose first letters form the word "AIM."

AWARENESS

• We must promote public awareness that suicides are preventable. We must enhance resources in communities for suicide prevention programs and mental and substance abuse disorder assessment and treatment. And we must reduce the stigma associated with mental illness that keeps many people from seeking the help that could save their lives. The problem of depression, for example is common in this country and throughout the world. Don’t be afraid or ashamed to seek help so that you can continue to be a productive person, or to refer a friend or loved one you believe to be at risk.

INTERVENTION

• We must complete our work with public and private partners on a National Strategy for Suicide Prevention. We must eliminate barriers in public and private insurance programs for provision of quality mental and substance abuse disorder treatments. We must institute training about suicide risk assessment, treatment, management and aftercare for all health, mental health, substance abuse and human service professionals—including clergy, teachers, correctional workers, and social workers.

• We need to develop and implement effective training programs for family members of those at risk and for natural community helpers on how to recognize, respond to, and refer people who show signs of suicide risk. Far too many health professionals are failing to ask about depression or to encourage patients to talk about it. In fact, about 70 percent of elderly suicide victims have seen a health care professional within the month preceding their suicide.

METHODOLOGY

• We need to enhance research to understand risk and protective factors related to suicide, their interaction, and their effects on suicide and suicidal behaviors. And we need to increase research on effective suicide prevention programs, clinical treatments for suicidal individuals and culture-specific interventions.

It is my hope that communities, policymakers, civic organizations and individuals will take these recommendations to heart and work to implement them. We must remember that prevention begins at home, and the work of suicide prevention must be done at the community level. At the same time, in the press kits which accompany the Call to Action, you will find fact sheets that not only outline the problem of suicide in the U.S., but lay out what the Federal government is doing and will continue to do in the area of suicide prevention. Senator Reid’s work to secure an appropriations hearing in the Senate will allow us to continue and intensify our efforts.

The Call to Action we are issuing today is only a beginning. Let us together leave here today committed to preventing suicide in our nation.

I understand that Mrs. Gore needs to leave us now, although she will shake a few hands with some of our partners on the way out. The rest of us will make ourselves available to the press for individual interviews. Thank you again for coming.

Last revised: January 4, 2007