# Beyond Risk Prediction: Considering Upstream Universal Suicide Prevention to Decrease Risk and Increase Resilience

## TL;DR

This paper argues for upstream suicide prevention strategies that build resilience and reduce risk before crises occur, rather than relying solely on individual treatments.

## Contribution

The paper proposes using low-intensity, universal interventions like Stress Control to build resilience and reduce suicide risk at a population level.

## Key findings

- Current suicide risk prediction methods are ineffective and lack focus on protective factors.
- Upstream interventions like Stress Control can reduce stress, anxiety, and depression while increasing well-being and resilience.
- Scalable, universal prevention strategies may help lower the U.S. suicide rate by addressing risk factors early.

## Abstract

Despite decades of research, suicide risk factors predict outcomes at chance levels, and there is a dearth of protective factor and resilience research, which limits the utility of risk-based approaches. Further, suicide prevention interventions primarily consist of individual psychotherapies and treating individuals after suicide-related outcomes occur. Unfortunately, there is a lack of upstream suicide prevention interventions targeting known suicide risk factors and aiming to increase well-being and resilience in the U.S. Thus, we discuss these problems in the field and the U.S. health care system and provide a possible solution. We propose using low-intensity, universal, and upstream prevention interventions, such as Stress Control. Stress Control is a classroom-style, Cognitive Behavior Therapy-based program shown to reduce “risk,” stress, anxiety, and depression and boost well-being and resilience as part of a stepped-care model. Although Stress Control’s suicide prevention effectiveness has not yet been directly assessed, we discuss how it could be a promising suicide prevention strategy with additional testing. A proposed mechanism for this reduction is building resilience to common risk factors and suicide ideation via evidence-based coping skills, thereby decreasing future suicide risk. We review current limitations and discuss how upstream, scalable, universal prevention interventions can help improve psychological resilience and reduce suicidal thoughts and behaviors, lowering the U.S. suicide rate. Implications and recommendations are discussed.