Addressing Suicide Prevention and Social Stigma through Systems Leadership
Challenge
Missouri Foundation for Health (MFH) recognized a critical problem within the state: disproportionately high rates of firearm-related suicides. Despite growing recognition of suicide as a public health crisis, Missouri faced unique challenges, with firearms accounting for a staggering 61 percent of suicide deaths and 85 percent of suicide attempts resulting in fatalities. Compounding efforts to address this issue was the pervasive stigma surrounding mental health and firearms, hindering open discourse and preventive efforts. Traditional grant funding models exacerbated these challenges, emphasizing short-term outcomes and predefined solutions that often failed to address the underlying systemic factors driving firearm suicides. Grantees were constrained by rigid reporting requirements and lacked the flexibility to explore innovative approaches or engage communities authentically.
Solution
In “The Dawn of System Leadership,” Peter Senge argues that “real change starts with recognizing that we are part of the systems we seek to change.” In response to these complex challenges, MFH pioneered the Firearm Suicide Prevention (FSP) initiative, adopting a systems leadership approach to catalyze transformative change. At the heart of the FSP initiative was a commitment to cultivating learning relationships and fostering meaningful dialogue within communities to dismantle stigma and challenge entrenched beliefs surrounding suicide and firearms. In 2021, MFH activated the Missouri FSP Learning Cohort with seven grantees. Openfields served as the Cohort’s facilitator, walking alongside the grantees and MFH through the complex process of starting community conversations, gathering and analyzing data, and generating long-term solutions for prevention.
Senge also says that system leaders “work to create space where people living with the problem can come together to tell the truth.” Embodying this approach, MFH sent grantees into communities to hold discourse and create safe spaces for difficult conversations. Part of the initiative’s work therefore was to create a dialog between community partners, experts, and target populations such as youth in the LGBTQ community, elderly white men, and families of suicide victims. Through this “systems mapping,” the learning cohort gained a picture of the realities, attitudes, and assumptions at work in communities and the ways in which they may be interconnected. In quarterly “sense-making sessions” and participatory workshops, grantees explored the root causes of firearm suicides, confronted stigma, and identified leverage points for intervention. Rather than prescribing predefined solutions, the project empowered grantees to explore novel approaches, prioritize relationship-building, and embrace uncertainty in pursuit of sustainable, community-driven change.
Impact
The FSP initiative yielded profound impacts on multiple levels, reshaping attitudes, narratives, and systems surrounding suicide prevention in Missouri. By prioritizing relationship-building and community engagement, grantees fostered trust, broke down barriers, and empowered individuals to seek support and share their stories without fear of judgment or stigma. Mental models shifted, with communities embracing more open and honest conversations about mental health and firearms, especially with grantees. Moreover, the initiative sparked broader systemic changes, challenging outdated policies and practices that perpetuated the cycle of firearm suicides. Through collaborative efforts, grantees developed innovative programs, expanded access to mental health resources, and advocated for evidence-based policies to reduce access to lethal means. The initiative’s emphasis on long-term, systemic change laid the foundation for a more resilient and compassionate approach to suicide prevention, ensuring that communities across Missouri could thrive and flourish.
"By prioritizing relationship-building and community engagement, grantees fostered trust, broke down barriers, and empowered individuals to seek support and share their stories without fear of judgment or stigma."
Read more about our work with MFH on Evaluating Firearm Suicide Prevention and our Learning Cohorts.
About Missouri Foundation for Health
The mission of Missouri Foundation for Health is to eliminate underlying causes of health inequities, transform systems, and enable individuals and communities to thrive.
