Suicide remains one of the most urgent and complex public health challenges in the United States, with more than 49,000 lives lost in 2023 alone. In this episode, ASTHO’s director of state health policy, JoAnne Deehr, breaks down how states are responding with more targeted, data-driven strategies.
Suicide remains one of the most urgent and complex public health challenges in the United States, with more than 49,000 lives lost in 2023 alone. In this episode, ASTHO’s director of state health policy, JoAnne Deehr, breaks down how states are responding with more targeted, data-driven strategies. From identifying high-risk populations like veterans, rural communities, and first responders, to investing in prevention infrastructure, Deehr explains how policymakers are moving beyond one-size-fits-all approaches. She also highlights key actions from the 2025 legislative session, including the creation of suicide prevention offices, advisory bodies, and fatality review processes designed to uncover patterns and improve interventions.
Legislative Snapshot: Suicide Prevention Infrastructure and AI Chatbots | ASTHO
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JOHN SHEEHAN:
This is Public Health Review Morning Edition for Tuesday, March 24, 2026. I'm John Sheehan for the Association of State and Territorial Health Officials.
Today, building smarter suicide prevention, we talk with ASTHO's director of state health policy, JoAnne Deehr, about how states are responding to this urgent and complex public health challenge with more targeted data-driven strategies like identifying high-risk populations and investing in prevention infrastructure. JoAnne Deehr, welcome to the show.
JOANNE DEEHR:
Thank you.
SHEEHAN:
So, JoAnne, can you give us a current scope of the suicide crisis?
DEEHR:
Yeah, the suicide crisis remains a significant public health challenge in the U.S. because it affects people across every age group, community, and region, and it's driven by a complex mix of individual, social, and structural factors. In 2023 alone, more than 49,000 Americans died by suicide, and after these rates rose steadily from the early 2000s through 2018, they've remained high with minor improvements across some population groups. With those rates remaining high across much of the country, we know that prevention requires sustained coordinated action, strengthening protective factors, improving access to care and crisis supports, and using data to target strategies where need is the greatest.
SHEEHAN:
Yeah, and as you say, even though it absolutely affects all of us, certain demographics are experiencing it more severely. Can you talk about the need to, sort of, understand those demographic differences and how that plays into strategy?
DEEHR:
Yeah, understanding the differences in outcomes across population groups and regions help states move from a one size fits all prevention approach to approaches that are targeted and data informed. So, when states recognize the risk is higher in certain groups, such as veterans or older adults, rural residents, and in certain industries like construction or public safety, they can better tailor investments and partnerships that might mean focusing on rural crisis response capacity, workplace-based prevention strategies, or ensuring that prevention infrastructure includes the right cross-sector partners to reach the populations and settings where risk is most concentrated.
SHEEHAN:
And you've written, one of the big components to addressing the suicide crisis is infrastructure, from offices to having personnel like coordinators available. So, based on on the 2025 legislative session, what approaches are states taking?
DEEHR:
Yeah, in the 2025 legislative session, states considered at least 30 bills related to suicide prevention infrastructure, including offices, coordinators, advisory bodies, and suicide review fatality processes, and of those, five were enacted. So, a key example is Delaware's bill, HB54, which establishes an Office of Suicide Prevention. They also passed HB87, which expands coalition membership to include members with lived experience. Other states are focused on strengthening governance and coordination through task forces and advisory structures, and some looked at formalizing fatality review processes. This reflects a broader trend towards building a durable system and supports surveillance, coordination, and evidence-based implementation.
SHEEHAN:
And several states are having acted advisory bodies like task forces or committees focused on first responders and addressing suicide and professions for first responders. How does that work?
DEEHR:
Yeah, task force and committees can create a structured forum for understanding what's driving risk in high exposure professions, and for identifying practical prevention strategies that fit the realities of those jobs. So, in states like Texas and Illinois, those advisory bodies are specifically tasked with studying prevention and peer support approaches, and gathering input from interested parties, and producing recommendations on policies and programs. Even when time-limited, they can help evaluate the issue, align agencies and professional groups, and translate frontline experiences into actionable guidance. Suicide fatality review teams systematically examine suicide deaths to better understand contributing factors and identify prevention opportunities by bringing together multidisciplinary partners, such as public health, healthcare professionals, and public safety, and these teams can identify patterns and gaps in services. States like Wisconsin are considering formalizing these processes in statute to support consistency, data sharing, and statewide coordination.
SHEEHAN:
In a recent article you wrote, also addresses the growing attention on AI and on chatbots, and sort of the intersection of mental health and people using chatbots. What are states doing to create guardrails and to address this apparently growing problem?
DEEHR:
Yes, AI. AI technology is advanced. Chatbots are increasingly used in mental health-adjacent settings. So, while these tools can expand access to information and support, they do not replace professional care and may present safety concerns, particularly for individuals experiencing suicidal ideation or those seeking support during a moment of crisis. In response, at least 19 states considered legislation regulating AI use in mental health context during this last session, and at least five of those enacted new laws. So, the guardrails states are adopting very some require clear disclosure and crisis referral protocols, others restrict or prohibit AI from providing or representing itself as providing behavioral health services, and then several include consumer protection measures related to data practices and advertising.
SHEEHAN:
So, as we've sort of talked about, there's a lot of, there's a lot of change on the horizon legislatively with things emerging like AI, and there's a lot of movement in, in suicide prevention. Why is it so important to stay on top of it?
DEEHR:
Yeah, staying informed about these matters right now is important because legislative activity is moving quickly in both areas, and state and territorial health agencies benefit from understanding the policy landscape as they plan, coordinate partners, and support evidence-based prevention strategies. In our article, we also point to ASTHO's Legal Map as a resource for understanding some of the structures that states have in statute and how policies are evolving.
SHEEHAN:
Joanne Deehr, thanks so much.
DEEHR:
Thank you.
SHEEHAN:
Joanne Deehr is director of state health policy at ASTHO.
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This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.
