Bubbling Up

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If ever there was time to discuss suicide, it was the week of June 4th. That Tuesday brought the news that fashion designer Kate Spade had taken her own life. On Friday, with Spade’s death still fresh on our minds, we were rocked by the suicide of celebrity chef and author Anthony Bourdain.

Then, as if on cue, the Centers for Disease Control and Prevention reported updated statistics on suicide, including the fact that suicide rates have increased 25 percent over the past two decades. Grimmer still, Missouri was one of the 25 states with an increase of more than 30 percent. We entered the weekend shocked and saddened, perhaps feeling – even fearing – that this wasn’t the end of such tragic news; the American Foundation for Suicide Prevention reported that 863 other people also died by suicide that week.

Like the opioid epidemic, we struggle to wrap our arms around this crisis. We feel helpless and frantic. At some point, the question is posed to governments, philanthropy, charities, and other funders: What are you doing about suicide (or mental illness or the opioid crisis, etc.)?

It’s a legitimate question. But due to the nature and purpose of philanthropy, for instance, the answer isn’t always immediately evident or the action noticeably linear. Private foundations (like Missouri Foundation for Health), mostly concentrate on the root causes of problems as opposed to charity, which is designed to meet immediate needs. In medical terms, it’s like working to prevent a disease rather than treating an illness after it occurs. Due to limited endowment dollars, foundations typically don’t support ongoing programs, instead they support new approaches to solving intractable problems and help test promising ideas. When compared to other funding sources, foundations are in a better position to take the risks needed to spark fundamental change.

Since suicide is rarely caused by a single factor, there is no one approach, strategy, or agency that a foundation can invest in to tackle such a complex problem. As a foundation, we focus on a public-health approach to address health issues, drawing on many disciplines and strategies.

It’s why we invested in a region-wide organizational learning collaborative and training effort centered on trauma and toxic stress; assisted a statewide coalition to plan and implement the federal Excellence in Mental Health Act to improve behavioral health access and treatment; and funded a mental health assessment to better gauge the needs of southwest Missouri.

It’s why we’ve helped enhance the continuum of care for those at risk of suicide by testing and evaluating a comprehensive telephone follow-up procedure; funded trauma training for public school staff; and financed an innovative approach to train gun shop and shooting range operators on suicide prevention. By building resilience, improving organizational capacity, increasing awareness, improving treatment access, and changing systems of care, these and other efforts work to address many of the social determinants that experts say increase the risk of suicide.

Increasingly, the role of foundations goes beyond grantmaking to include convening stakeholders around specific problems, building collaborations to leverage the power of providers working on similar issues, and partnering with communities (some often overlooked, some atypical) to learn about local issues from different voices. This approach better ensures viable long-term strategies and lasting change. In short, foundations are challenged with being proactive and working systemically with limited resources while often in the midst a crisis. It’s why over the past few years we’ve adopted a broader, more proactive approach to our behavioral health work, paying more attention to how it connects with our efforts in housing, schools, and policy. Over the next few years we will expand on that strategy as we focus on researching and assessing the complexities of Missouri’s behavioral health system, piloting and spreading innovative solutions, and working collaboratively on policy and advocacy.

Experts agree that if any change is to be made, it will be achieved through a broad-based approach focused across the individual, family, and community – across all levels of society, private and public.

Learn more about national and state efforts:

Missouri’s Regional Suicide Prevention Conferences (July-September in Cape Girardeau, Columbia, Kansas City)
Missouri Suicide Prevention Plan: A Collaborative Effort Bringing a National Dialogue to the State (Missouri Department of Mental Health)
Preventing Suicide: A Technical Package of Policy, Programs, and Practices (CDC)
Strategic Plan for Prevention 2017-2020 (Department of Mental Health-Division of Behavioral Health

Michael Renner is a program officer at Missouri Foundation for Health.