We Can Do This Together:
Reducing the Annual Suicide Rate 20% by 2025

The American Foundation for Suicide Prevention launched Project 2025 to lead a plan of action aimed at the bold goal of reducing the annual suicide rate 20% by 2025. It was the first large-scale, comprehensive effort to determine where we can reduce suicide through the most promising programs and interventions.

To do so, we assembled the top minds in the field and used dynamic data modeling to determine which prevention methods could have the greatest impact. Based on those initial findings, we identified four critical areas to save the most lives in the shortest amount of time:

  • Firearms icon Firearms
  • Healthcare Systems icon Healthcare
    Systems
  • Emergency Departments icon Emergency
    Departments
  • Corrections Systems icon Corrections
    Systems

Our findings revealed that our task was achievable – but we can’t do it alone. By engaging in key strategic partnerships within these four critical areas, we can achieve meaningful systemic change.

Together, we are mobilizing institutions, associations and individuals in a collective effort to employ evidence-based practices and research to drive policy, increase understanding of mental health, and save lives.

Volunteer spotlight

I want to see our suicide rates drastically reduced. That means we all need to be open, and know it’s okay not to be okay sometimes.

Tabitha Childers
Arkansas Chapter

Read more
Firearms icon

Firearms

Nearly 23,000 people are lost each year to suicide by firearm. 51% of all suicides in the U.S. are by firearm, and 60% of all firearms deaths are suicides.

It’s crucial that we make suicide prevention education a basic component of firearms ownership.

It’s been estimated that if half the people who purchase firearms are exposed to suicide prevention education, we can expect an estimated 9,500 lives saved through 2025.

Through Project 2025, we educate the firearms-owning community on how to spot signs of suicide risk, implement safe storage practices, and promote help seeking at times of distress.

We’ve partnered with the National Shooting Sports Foundation to distribute suicide prevention materials to its national network of retailers and ranges, as well as forging partnerships with other firearm organizations that want to save lives from suicide.

Our free education program Talk Saves Lives: An Introduction to Suicide Prevention for Firearms Owners has been presented 40+ times in communities
across the country, with
600+ participants
Healthcare Systems icon

Healthcare Systems

Up to 45% of people who die by suicide visit their primary care physician in the month prior to their death.

By identifying one out of every five at-risk people in large healthcare systems – such as during primary care and behavioral health visits – and providing them with short-term intervention and better follow-up care, it’s been estimated that we can save 9,200 lives by 2025.

Project 2025 is collaborating with the country’s largest healthcare systems and accrediting organizations to accelerate the acceptance and adoption of risk identification and suicide prevention strategies we know work.

Prevention Training for Primary Care

AFSP has partnered with SafeSide Prevention, founded by Dr. Tony Pisani, suicide prevention expert and primary care psychologist, to offer video-based suicide prevention training for primary care through our local chapters across the county. The SafeSide Prevention CARE training provides primary care providers a framework for responding to suicide concerns within the time and resource constraints of their primary care practice, establishing a common language and process for clinicians and staff. For organizations implementing a Zero Suicide approach, which aims to create a health system that is smarter and safer for suicide care, the SafeSide framework will fulfill their need to build a competent, caring workforce.

Since 2019, we have partnered with SafeSide Prevention to provide training to 51 primary care practices, reaching 738 physicians, nurses, and staff across the country, including locations in Georgia, North Dakota, New York, South Carolina, Oregon, and California.

We have recently partnered with our first large healthcare system - Lexington Medical Center (LMC) in West Columbia, South Carolina. The system, which includes three community medical centers, with a staff of more than 7,800 health care professionals, provides care to roughly 322,000 patients each year, and operates one of the busiest emergency departments in South Carolina.

Through a grant co-funded by AFSP’s South Carolina Chapter and the Lexington Medical Center Foundation, the LMC Physician Network is providing SafeSide Primary CARE training in 34 physician practices (which includes roughly 500 providers, clinical staff and administrative staff) as the health system works to integrate mental health into their organizational culture.

AFSP has collaborated with the National Action Alliance for Suicide Prevention to publish “Recommended Standard Care for Suicide Prevention in Healthcare,” which provides guidelines for suicide prevention best practices in various healthcare settings including primary care, behavioral health, and emergency departments.

Through our advocacy work, we are also supporting state-level legislation and regulatory efforts for training of health professionals in suicide assessment, treatment, and management to be required in all 50 states and the District of Columbia.

Emergency Departments icon

Emergency Departments

Thirty-nine percent of people who die by suicide make an emergency department visit in the year prior to their death. Therefore, emergency departments present another key setting with a tremendous opportunity to save lives.

By educating and equipping emergency department physicians and staff with the suicide prevention tools they need to better screen and care for at-risk patients in EDs and other acute care settings, we can provide a safety net. It’s been estimated that by screening one out of five people seen in emergency departments, and providing short-term interventions such as Safety Planning and follow-up care, we can expect an estimated 1,100 lives saved through 2025.

One of the biggest challenges to suicide prevention in EDs is the absence of a quick and easy-to-follow procedure for emergency physicians to assess for suicide risk and to provide immediate care. AFSP has partnered with the American College of Emergency Physicians (ACEP) to develop and deliver a rapid suicide risk assessment and suicide prevention intervention tool called “I Care Too” (ICAR2E). The tool is freely available online for use by any emergency physician, nurse, or medical student.

This year, we also honored the developers of the Emergency Psychiatric Intervention (EPI), a new toolkit of best practices for patients with psychiatric emergencies. EPI was developed by a team of experts on the frontlines of emergency medicine and acute psychiatry with Vituity, a physician-owned-and-led multi-specialty partnership. The toolkit prepares emergency physicians and staff to quickly evaluate and treat patients who may be experiencing a mental health emergency or showing signs of suicidal thoughts or behaviors. EPI provides guidance for care teams in areas from initial diagnosis and treatment to discharge protocols, which could include outpatient referrals, prescription refills, or other important information.

After several months of using the new tool, average wait times for lower-risk patients were cut by 40%, and patients who were assessed by teams who had rolled out the EPI bundle had yet to revisit the hospital.

The ICAR2E Tool has been made available to ACEP’s 40,000+ members
Corrections Systems icon

Corrections Systems

Suicide is the leading cause of death in jails and has increased 30% in prisons in recent years.

Incarcerated people are particularly vulnerable to suicide, for a variety of complex reasons. It’s been estimated that by screening for and identifying 50% of at-risk individuals at key points within the corrections system, such as at times of entry and exit – and delivering comprehensive care that addresses both physical and mental health – we can expect an estimated 1,100 lives saved through 2025.

Project 2025 provides the tools to help leaders and staff in corrections settings best care for and respond to at-risk adults in custody, as well as better care for their own mental health.

AFSP has partnered with The National Commission on Correctional Health Care to create a comprehensive guide, “Suicide Prevention Resource Guide: National Response Plan for Suicide Prevention in Corrections,” for preventing inmate suicide impacting the nearly 500,000 people served in NCCHC accredited facilities every day. The guide, which is also available to the public, provides a road map for navigating the complexities of suicide prevention in correctional settings, including assessment, intervention, and training.

This past year, we piloted the new education program Talk Saves Lives for Corrections Staff in Massachusetts, to four separate audiences within the state. The program introduces those who work in corrections to suicide risk factors and warning signs, and best practices for safety, with a specific, customized focus on the correctional environment. Participants learn how to care for adults in custody, while also attending to their own wellbeing, in consideration of the unique stresses and challenges involved in working in a correctional facility. The pilot program received extraordinary feedback, with the full program expected to officially launch in 2021.

The road to 2025
2014 CEO Robert Gebbia and Board Chair Nancy Farrell decide to lead a plan of action aimed at the bold goal of reducing the annual suicide rate 20 percent by 2025
2015 An advisory committee of the leading experts in the field of suicide prevention is formed to establish priorities and guide the project
2016 AFSP announces primary focus areas of Project 2025
2016 AFSP funds 5 research projects examining the four Project 2025 areas
2017 AFSP officially announces a Project 2025 partnership with the National Action Alliance for Suicide
2018 AFSP formally expands partnership with the National Shooting Sports Foundation into a large scale, nationwide effort to educate firearms owners in suicide prevention
2018 Project 2025 is officially endorsed by the Department of Defense and the Department of Veterans Affairs as a partner in preventing suicide for service members and veterans
2018 AFSP funds additional Project 2025-focused research grants, reaching a $11.2 million investment
2019 Phase 2 of Project 2025 launches, with new partnerships with organizations including Aetna, the American College of Emergency Physicians (ACEP), the Coalition on Psychiatric Emergencies, the National Commission on Correctional Health Care (NCCH), and SafeSide Prevention, and the debut of a new interactive website
2020 CDC increases suicide prevention funding by $10 million, with many state plans using CDC’s guidance incorporating the Project 2025 focus areas
2021 CVS-AETNA supports Project 2025 by setting its own goal to reduce suicide attempts 20% by 2025