In 1997, Tennessee ranked 16th in the rate of suicide, at a rate of 13.6 per 100,000, compared to 11.4 nationally. Nationally, suicide rates have increased in the 10-19 age group and among young African-American males since the 1940's, according to the Centers for Disease Control. It has been suggested that as the African-American middle class grows, more African-Americans experience middle-class stresses and adopt middle-class responses. Although a previous suicide attempt is considered a major risk factor for suicide, no national data are compiled. Tennessee plans to start an anonymous reporting system; however, an estimated 5 million Americans have unsuccessfully attempted to kill themselves, and there are an estimated 765,000 attempts annually. In 1998 a collaboration of national public and private groups held a conference to analyze the problem. The results of this conference have been compiled in "The Surgeon General's Call to Action." The National Strategy for Suicide Prevention is organized around (AIM): awareness, intervention, and methodology. Tennessee's proposed plan to fight suicide includes creating a statewide toll-free suicide hotline; improving media cooperation; supporting local Survivors of Suicide and Suicide Anonymous meetings; education efforts; increased collaboration with clergy, teachers, health care professionals, and others who regularly encounter people under stress; and encouraging workers to earn certification from the American Association of Suicidology. 1 figure and a list of risk factors for suicide