The Development, Progress, and Impact of National Suicide Prevention Strategies Worldwide.

National suicide prevention strategies have been identified as evidence-informed interventions that require multisectoral efforts by governments. This article reviews the rationale for national strategies, the need for a whole-of-government approach, and current progress on national strategies worldwide, including successes and challenges regarding implementation. We highlight the limitations of existing evidence and describe how future research may help to address knowledge gaps. We conclude that national strategies are an important tool for suicide prevention worldwide. However, a more robust evidence base evaluating the impact of strategies on suicide-related outcomes is needed.

Suicide and Suicide Prevention From a Global Perspective.

In this introductory chapter, we provide the background and rationale for the compilation of overviews of national suicide prevention strategies from all geographic regions globally. Currently, suicide is the second leading cause of death among young people aged 15-29 years at global level. Overall, suicide rates in low- and middle-income countries (LMIC) are lower than the rates in high-income countries (HIC) of 11.2 per 100,000 compared with 12.7 per 100,000 population, but the majority of suicide deaths worldwide occur in LMICs. However, there are ongoing challenges in relation to the accuracy of suicide figures in many countries. The rationale for the global approach to suicide prevention is linked to major strategic documents provided by the WHO, including the Global Mental Health Action Plan, 2013-2020, the WHO report Preventing Suicide: A Global Imperative, in 2014, and the United Nations Sustainable Development Goals (SDGs) for 2030, including a target of reducing premature mortality from noncommunicable diseases by one-third, with suicide mortality rate identified as an indicator for this target. In addition, a review is provided of the evidence base and best practice of suicide prevention programs.

The international association for suicide prevention: the first 50 years.

BACKGROUND: The International Association for Suicide Prevention (IASP) was established in Vienna in 1960 and celebrated its 50th year in 2010. AIM: To review its 50 years of progress. METHOD: An historical and current review of activity. RESULTS: The IASP has members in over 50 countries and is today the key nongovernment organization in official relations with the World Health Organization in addressing the topic of suicide. It has increased communication and collaboration in suicide prevention worldwide and promoted the development of collaborative suicide prevention efforts, research, and program evaluation. LIMITATION: It is acknowledged that this is not an exhaustive review, and that other good work has probably been undertaken, but not referred to. CONCLUSION: The IASP has not only brought global attention to the unacceptable loss of approximately 1 million people worldwide who die each year by suicide, but it has been instrumental in establishing suicide prevention research and program evaluation in an increasing number of countries.

Evaluation of acceptability and use of lockable storage devices for pesticides in Sri Lanka that might assist in prevention of self-poisoning.

BACKGROUND: Self-poisoning with pesticides is a major reason for high suicide rates in rural areas of many developing countries. Safer storage of pesticides may be one means of prevention. We have conducted a study to assess the acceptability and use of lockable boxes for storing pesticides in rural Sri Lanka. METHODS: Four hundred lockable metal storage boxes were given to farming households, 100 in each of four villages. Assessment interviews were conducted by Sumithrayo (NGO) field workers immediately after boxes were supplied (T1), 11 - 14 weeks later (T2), 30 weeks later (T3), and 18 months later (T4). Data on suicide and self-harm were collected from local police and hospitals. RESULTS: At T1 only 1.8% (7/396) of households reported locking up pesticides, 72.5% (279/385) easy access to pesticides for adults and 50.4% (195/387) easy access for children. At T3 most informants in households using pesticides reported using the box all (82.3%, 298/362) or most of the time (7.2%, 26/362). Informants usually reported always locking the box (92.8%, 336/362) and most boxes were locked on inspection (93.6%, 339/362). By T4 there was some reduction in reporting that the box was kept locked all of the time (75.2%, 267/355) and the box being locked on inspection (73.8%, 262/355). Easy child access to the key was reported in relatively few households (10.7% at T4), although interviewers judged that this was possible in rather more (20.6%). Most informants regarded the box as useful (100% at T3 and 99.4% at T4), with convenience for storage, security, avoiding wastage, and protection of children being major factors. A message on the box about how to deal with bad feelings and the importance of safer storage was well received. The locks had been broken or the key lost in a few households. CONCLUSION: Introduction of lockable boxes for storing pesticides to farming households in Sri Lanka appeared to be acceptable. Most households used the boxes responsibly, although there was some decline in the proper usage over time. A large-scale trial of lockable storage devices in farming households in rural areas as a means of prevention of suicide and accidental poisoning is now indicated.