<\/span><\/p>\n
- \n
- Advance proven and effective ways to prevent suicide.<\/li>\n
- Share resources, solutions, and hope with people in a mental health crisis.| Offer clear action steps to keep people safe.<\/li>\n
- Help and support people who are impacted by suicide.<\/li>\n
- Reduce the number of deaths by suicide in North Carolina.<\/li>\n
- Create tailored prevention strategies and improve access for all people.<\/li>\n<\/ul>\n
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Our Work<\/h2>\n
At the Suicide Prevention Institute, a major part of our mission is to reduce deaths by suicide. We use science to guide this work. Science helps us find people who face greater risks of suicide and use strong evidence to guide our interventions.\u00a0\u00a0<\/span><\/p>\n
The graphic below shows a useful model of suicide prevention. A suicide attempt is like a waterfall in a stream. Prevention work can happen far upstream, near the waterfall, or downstream. Those levels can also be called primary (upstream), secondary (midstream), and tertiary (downstream).<\/span><\/p>\n\n
- \n\n \n \n
- \n\n \n \n\n Primary Prevention (Upstream)\n <\/a>\n\n <\/li>\n\n \n \n
- \n\n \n \n\n Secondary Prevention (Midstream)\n <\/a>\n\n <\/li>\n\n \n \n
- \n\n \n \n\n Tertiary Prevention (Downstream)\n <\/a>\n\n <\/li>\n\n \n<\/ul>\n\n
\n\n \n\n \n Primary prevention addresses the root causes of suicide. This includes trauma, the ongoing mental health crisis, poor access to health care, and other risk factors.<\/p>\n![\"\"](\"https:\/\/www.med.unc.edu\/psych\/wp-content\/uploads\/sites\/839\/2026\/03\/SPI-Upstream-1024x539.jpg\")
<\/p>\n\n\n\n\nExamples of primary prevention (upstream) strategies include:<\/b><\/p>\n<\/div>\n<\/div>\n
\n\n- \n
- Programs that enhance social connectedness (school-based programs, community events, etc.).<\/span><\/li>\n
- Programs that support high-risk and underserved groups of people (veterans, rural, older adults, firearm safety, etc.).<\/span><\/li>\n
- Resources for the development, implementation, and evaluation of interventions that prevent suicidal behaviors.<\/span><\/li>\n
- Governmental policies that improve economic supports in communities<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n <\/div>\n\n \n
\n \n Secondary prevention identifies people who face emerging risks. It also intervenes to keep them safe and connects them to the right supports to prevent a suicidal crisis.<\/p>\n![\"\"](\"https:\/\/www.med.unc.edu\/psych\/wp-content\/uploads\/sites\/839\/2026\/03\/SPI-Midstream-1024x539.jpg\")
<\/p>\n\n\nExamples of secondary prevention (midstream) strategies include:<\/b><\/p>\n<\/div>\n<\/div>\n
\n\n- \n
- Screening for mental health conditions and suicidal thoughts (schools, primary care, and pediatric settings, etc.).<\/span><\/li>\n
- Programs that decrease stigma and normalize help-seeking and help-giving behaviors (public awareness campaigns, education on safe messaging, etc.).<\/span><\/li>\n
- Training for people and populations about how to talk to other people about suicide (courses, events, virtual, etc.).<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n <\/div>\n\n \n
\n \n Tertiary prevention guides the response to suicidal crises. It also promotes approaches to these crises that have connection, dignity, and empowerment (and not fear).<\/p>\n![\"\"](\"https:\/\/www.med.unc.edu\/psych\/wp-content\/uploads\/sites\/839\/2026\/03\/SPI-Downstream-1024x539.jpg\")
<\/p>\n\n - Programs that decrease stigma and normalize help-seeking and help-giving behaviors (public awareness campaigns, education on safe messaging, etc.).<\/span><\/li>\n
- Programs that support high-risk and underserved groups of people (veterans, rural, older adults, firearm safety, etc.).<\/span><\/li>\n
- \n\n \n \n\n Secondary Prevention (Midstream)\n <\/a>\n\n <\/li>\n\n \n \n
- \n\n \n \n\n Primary Prevention (Upstream)\n <\/a>\n\n <\/li>\n\n \n \n