Our State, Our Wellbeing

Partnering to Prevent Suicide in NC

A 12-month initiative to identify and implement strategies to improve mental health and reduce the number of suicides in North Carolina, launched by Carolina Across 100 and the UNC Suicide Prevention Institute.

In 2021, North Carolina lost 1,448 lives to suicide. [1]

Both the total number and the rate of suicides have increased in North Carolina over time. The total number of suicides in the state increased by more than 40% from 2004 to 2020, while the rate per 100,000 residents grew by more than 10%.[2] The COVID-19 pandemic only exacerbated challenges with mental health and increased risks of suicide in communities, with disruption to people’s lives and routines, as well as increased feelings of disconnection and isolation.

This issue spans demographic groups, geographies, and other categories. Many significant populations in North Carolina find themselves at elevated risk of suicide.

More than 1 in 10

North Carolina high school students reported attempting suicide in 2021, with even higher rates for students who identify as female (23%), Black (14%), American Indian/Alaska Native (16%), and LGBTQ+ (22%).

1 in 10 people

Urban Vs. Rural

North Carolina’s rural residents had a suicide rate 1.2 times higher than their urban counterparts in 2020

Urban vs. Rural suicide rates

Veterans in North Carolina

have an average suicide rate 2.5 times higher than non-veterans, accounting for nearly 20% of all suicide deaths in the state between 2015 and 2019.

Suicide Rates: Age group by sex, 2019

Suicide rates: Age group by sex 2019

The number or rate of suicides cannot tell the full story. For each individual who dies by suicide, many more consider suicide, attempt it, or receive medical care for self-harm. And each death by suicide leaves a lasting impact on loved ones, friends, and community members. As many as 135 people may be affected by each individual suicide.[3]

Our communities face an enormous challenge as mental health and suicide worsen in our state. The impacts are evident not only in therapists’ offices and doctors’ examination rooms but also in our homes, our schools, our workplaces, and our community institutions. Addressing this challenge will require a coordinated effort across our communities to understand who is most vulnerable and why, align resources and services to increase the accessibility and quality of supports available, and overcome stigma and other factors that make it difficult for people to seek help and for communities to respond.

To meet this moment, Carolina Across 100 is launching a 12-month program supporting a group of community collaboratives seeking to identify and implement strategies to improve mental health and ultimately reduce the number of suicides in North Carolina.

Program Basics

Carolina Across 100 seeks applications from communities that are interested in working across sectors to prevent suicides and improve mental and behavioral health in the state. Teams will build collaboratives within their communities and benefit from peer learning with each other to better understand the context and impacts of suicide and related issues, as well as design and implement strategies to respond effectively. Communities that wish to apply for the program must submit an online application by July 28.

Participating communities will receive these benefits

Community Selection

A panel of Carolina Across 100 representatives will select 10-12 communities to participate in the 12-month program. Communities may apply as individual county teams, a municipal-county partnership, or a multi-county collaborative. Communities will be selected based on the following criteria:

  • Identification of a core team composed of individuals from different sectors

  • Demonstration of community commitment through at least three letters of support from different sector partners

  • Prior experience with cross-sector public health collaborations, community-based approaches to mental and behavioral healthcare, and/or suicide prevention

  • Understanding of vulnerable populations in their communities, factors that contribute to suicide and related mental and behavioral health challenges, and barriers to quality, availability, and access to programs

  • Diversity of geography, economy, and demography among applicants

    Note: The selection panel will prioritize applicants from counties that have not yet participated in a prior Carolina Across 100 program. To see which counties have previously participated in Carolina Across 100, please view this map.

Team Formation

After selection for the program, the core team identified in the application will identify the full community team (local collaborative). Given the differences among communities, the composition of the teams will vary and the ncIMPACT Initiative will support stakeholder identification. However, we expect that each collaborative will include a diverse set of sectoral stakeholders, all committed to active participation in the program.


Each community collaborative must be prepared to meet monthly over the course of the program to develop and implement a cogent strategy that (1) leverages existing assets and activities, (2) increases the availability, quality, and alignment of community resources for suicide prevention and mental and behavioral health, and (3) addresses barriers to access for supports and interventions, especially for higher-risk subpopulations.

What strategies are working to improve mental health and reduce suicides in your community?

Doing More, Together

Suicide is a shared problem, touching every community in our state. By partnering on prevention, we can build on the data, tools, and resources available to help communities strengthen their local response. Help your community get involved.

**If you or someone you know are thinking about suicide, call or text the Suicide & Crisis Lifeline at 988.**