When I tell people I work in suicide prevention, they often assume I spend my days answering crisis calls or serving as a counselor. Those roles are essential. But the assumption reveals something deeper about how we, as a society, think about suicide prevention. We picture it at the moment of crisis. We rarely picture everything that comes before.

For decades, our national approach to suicide prevention has leaned heavily on intervention and treatment. We search for warning signs and utilize screening tools that inform us if someone may be struggling. We build hotlines and crisis teams. We train people to respond when someone reaches a point of such despair that they want to die. 

These tools save lives every day, and we must continue to strengthen them. But if we want fewer people to reach that point of despair in the first place, we need to expand our vision for what suicide prevention is and what it can be.

Our current paradigm is often belatedly deployed only once a suffering person reaches a breaking point. We provide training to help people notice and support someone who may be in crisis, then attempt to plug them into a mental health system that is too often inaccessible and overburdened. We have placed the greatest weight on the most fragile moment.

The field of public health offers a roadmap for a better way. There was a time, in the 1960s and 70s, when heart disease prevention focused almost entirely on emergency interventions like CPR and cardiac surgery after a heart attack. We have drastically reduced deaths due to heart disease by 66% in the U.S. from 1970 to 2022. However, CPR training, better surgical techniques, and putting defibrillators in shopping malls were only a part of this success. Improving nutrition, reducing tobacco use, and establishing social and cultural norms around........

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