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Suicide is a complex problem that requires a range of prevention initiatives and methods of evaluation

  • Keith Hawton (a1) and Jane Pirkis (a2)
Summary

A range of factors can contribute to suicide, which means that a multifactorial approach to suicide prevention is necessary. Whereas randomised controlled trials may be suitable for evaluation of some interventions, others require different approaches for assessment of their impact. Also, suicide itself will not always be the most feasible outcome measure.

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Copyright
Corresponding author
Keith Hawton, Centre for Suicide Research, University Department of Psychiatry, and Oxford Health, NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, UK. Email: keith.hawton@psych.ox.ac.uk
Footnotes
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See pp. 396–402, this issue.

Declaration of interest

None.

Footnotes
References
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1 World Health Organization. Preventing Suicide: A Global Imperative. World Health Organization, 2014 (http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/).
2 World Health Organization, Western Pacific Region. Towards Evidence-Based Suicide Prevention Programmes. World Health Organization, Western Pacific Region, 2010 (http://www.wpro.who.int/mnh/TowardsEvidencebasedSPP.pdf).
3 Riblet, NBV, Shiner, B, Young-Xu, Y, Watts, BV. Strategies to prevent death by suicide: a meta-analysis of randomised controlled trials. Br J Psychiatry 2017; 210: 396402.
4 Hawton, K, Bergen, H, Simkin, S, Wells, C, Kapur, N, Gunnell, D. Six-year follow-up of impact of co-proxamol withdrawal in England and Wales on prescribing and deaths: time-series study. PLoS Med 2012; 9: e1001213.
5 Department of Health. Preventing Suicide in England: Third Progress Report of the Cross-Government Outcomes Strategy to Save Lives. Department of Health, 2017 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/582117/Suicide_report_2016_A.pdf).
6 Hawton, K, Witt, KG, Salisbury, TL, Arensman, E, Gunnell, D, Hazell, P, et al. Psychosocial interventions following self-harm in adults: a systematic review and meta-analysis. Lancet Psychiatry 2016; 3: 740–50.
7 Mann, JJ, Apter, A, Bertolote, J, Beautrais, A, Currier, D, Haas, A, et al. Suicide prevention strategies. A systematic review. JAMA 2005; 294: 2064–74.
8 Zalsman, G, Hawton, K, Wasserman, D, van Heeringen, K, Arensman, E, Sarchiapone, M, et al. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 2016; 3: 646–59.
9 Pirkis, J, Too, LS, Spittal, MJ, Krysinska, K, Robinson, J, Cheung, YT. Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis. Lancet Psychiatry 2015; 2: 9941001.
10 National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Making Mental Healthcare Safer: Annual Report and 20-Year Review. University of Manchester, 2016 (http://research.bmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/reports/2016-report.pdf).
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Suicide is a complex problem that requires a range of prevention initiatives and methods of evaluation

  • Keith Hawton (a1) and Jane Pirkis (a2)
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