Suicide seldom shatters just one life. Out of the grave crawls guilt for the living and anguish over the dead. Suicide rips families apart. It causes grief, anger, shame, divorce, and-sometimes-other suicides. The pain felt by those who take their own lives doesn't end with their deaths; it moves on to haunt the hearts and minds of the living.

Kristin Silver is a family suicide survivor who lost her 13-year old brother George to suicide. In her public testimony, she described how his death affects her still.

"On March 12th of last year, I woke up to discover I was no longer living in a family of 5. I no longer had a brother. . . Why? Because my baby brother was in so much pain, he decided life wasn't worth it anymore. Because no one told him he could feel better, he didn't think he ever would. . . Because he was suffering, all he could think of was how to end his pain. . . .I look at his attempts at self-medication through drugs and am filled with a defeating and devastating sense of sadness, the kind that weaves itself into every nook and cranny of your life and settles into the deepest, most vulnerable places in the abyss of a broken heart."

At the too-young age of 15, Kristen Silver has been damaged by a death she cannot comprehend, but which she knows could have been prevented.

Suicide IS preventable. It is a very serious public health problem, but it can be effectively confronted by a caring public involved in a public health solution, as proposed through the National Strategy for Suicide Prevention. The public health approach has helped our Nation address problems as diverse as heart disease and automobile fatalities-it can also help us effectively address and defeat suicide.

The public health approach reflected in the National Strategy represents a rational and organized way to implement prevention efforts and ensure they are effective. Its framework for action, however, is built around the imperative that we fully engage both the public and private sector in its implementation. As clearly demonstrated by the scope of its 11 goals and 68 objectives, effective suicide prevention hinges on involving all facets of society in prevention efforts.

We have, at this time, an unprecedented opportunity to educate the public about suicide prevention as a critical public health priority. In July, the President's New Freedom Commission on Mental Health released its final report called Achieving the Promise: Transforming Mental Health Care in America. This historic document is a very straightforward description of the problems of our current mental health care system. It outlines how we must correct these gaps if we are to deliver a mental health care system that focuses on recovery and helps vulnerable people "build resilience to face life's challenges." These words have particular resonance when we speak of suicide prevention.

The very first recommendation of the New Freedom Commission report urges us to implement the National Strategy for Suicide Prevention. In order to accomplish so broad a task, the Commission reiterates a vital next step called for in the National Strategy. This vital step is the formation of a national-level public/private alliance that can advance and coordinate implementation of its goals and objectives.

Our challenge here today is to ensure that efforts to develop a framework for a public-private alliance for suicide prevention incorporate the opportunities and recommendations presented by the New Freedom Commission's report.

The National Strategy stresses that the alliance, which will provide a national focal point for action, must reflect the need for broad-based partnerships. A successful alliance will involve all key stakeholders in collaborative efforts that:

Build bridges between Federal, State, national, and community groups that need to be involved in understanding and confronting the complexities of suicide.

Identify and surmount barriers that keep groups from working together most effectively, and demonstrate that suicide prevention is a shared responsibility, extending from the Federal level, to the community level, to the individual level. This responsibility includes sharing the financial support needed to build and sustain a national-level public/private alliance for suicide prevention.

At the Federal level, SAMHSA and other agencies within the Department of Health and Human Services are focusing on the more global issues of a public health initiative, such as coordinating the implementation of the two National Strategy goals related to methodology. These goals are "to improve and expand surveillance systems" and "to promote and support research on suicide and suicide prevention."

Efforts to support these goals are already underway. For example, SAMHSA's Indicators of Success initiative is identifying measures of progress, and sources of baseline data, for each of the National Strategy's 68 objectives. The Centers for Disease Control and Prevention (CDC) currently is working on the National Violent Death Reporting System (NVDRS) and conducting a multi-State survey of suicide prevention planning processes. Information collected through these efforts will add to our knowledge about suicide and suicide prevention efforts so that we can best allocate our resources.

SAMHSA is advancing other broad National Strategy goals through new and ongoing programs. Our newly created Center for Addressing Discrimination and Stigma, or the ADS Center, is expanding our capability to fight stigma through national public education campaigns. The new SAMHSA-funded National Suicide Prevention Resource Center is increasing our capacity to work with States and community groups on local suicide prevention-planning efforts.

In addition, we are expanding accessible mental health care services at the community level through numerous grant programs. New paradigms for prevention are being developed and tested under SAMHSA in partnership with its sister agencies. These are the kinds of national activities through which we at the Federal level can take the lead in supporting implementation of the National Strategy.

It's extremely critical to successful implementation of an effective national strategy, however, that additional groups, including those that may never have considered public health as part of their purview, recognize the role they can play. For example, one goal within the National Strategy is that we "promote efforts to limit access to lethal means of self-harm." The objectives for this goal point to the necessity of collaborating with all stakeholders, including the auto industry, the pharmaceutical industry, gun proponent groups, and gun manufacturers in achieving this goal. Another goal of training persons to recognize at-risk behavior and deliver effective treatment involves groups as diverse as the clergy, educators, and criminal and divorce lawyers.

The National Strategy repeatedly stresses the importance of engaging new partners at the community level. The community level is where public policy is transformed into public action and real opportunities to save lives occur.

We need to educate local businesses and community leaders about their potential to help prevent suicide through the promotion and provision of better mental health care. Many people at work and within their communities silently suffer continuing mental anguish because they fear the stigma that so often accompanies treatment. What incredible progress we could make if employers and community leaders used their power as role models to eradicate a culture of intolerance in the workplace and in the community.

In the words of Kristin Silver,

"Healthy people do not kill themselves, but in a world of stigma and stereotyping, this fact escapes many. Our society needs to be educated so that [people with] mental illnesses receive the treatment they require."

One responsibility of the national-level alliance will be to help others at the Federal, State, and local levels achieve the same level of conviction as Kristin Silver, without suffering the personal anguish that she and her family experienced. To accomplish this, the alliance will have to provide a national vision that makes everyone see suicide as a national public health problem requiring them to be part of the solution.

It is now up to you to use your collective wisdom. It's up to you to spearhead a movement to create a national-level public/private alliance reflecting a common goal and shared resources and responsibilities. It's up to you to guide implementation of the National Strategy. It will not be easy, but it is critical to saving the lives and families of those who even today are contemplating suicide.

Kristin Silver recognized that there were other suicide survivors, like herself, who would eventually recover from their losses. "But," she said, "there are others out there, like my brother [George], who appear to have nothing to be sad about, but underneath their cheery exteriors hold death wishes, violent thoughts, and hopeless despair."

I believe that people care enough today to work toward seeing that the problem of suicide gets immediate attention and immediate resolution. Let's do what we can to unite ourselves and others in giving back to those persons contemplating suicide the hope that tomorrow is a day worth living for. Thank you.