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Strategies for preventing suicide

Published online by Cambridge University Press:  03 January 2018

Glyn Lewis ,
Keith Hawton  and
Peter Jones
Glyn Lewis*
Affiliation:
University of Wales College of Medicine
Keith Hawton
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX
Peter Jones
Affiliation:
Duncan Macmillan House, Department of Psychiatry, University of Nottingham, Porchester Road, Nottingham NG3 6AA
*
Glyn Lewis, Division of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN. e-mail: wpcghl@cardiff.ac.uk
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Abstract

Background

The Health of the Nation includes a target for reducing population suicide rates. We have examined and quantified various high-risk and population-based strategies for prevention based upon a number of stated assumptions and hypothetical interventions.

Method

The published literature was used to estimate the population attributable fractions for both high-risk and population-based strategies. The number needed to treat for the high-risk strategies was calculated, assuming an intervention that reduced suicide rates by 25%

Results

Interventions that would reduce rates of suicide by 25% would reduce population rates by about 2.6% for those recently discharged from hospital and by up to 5.8% for those presenting to general hospital with deliberate self-harm. The population attributable fraction for unemployment was 10.9%

Conclusions

High-risk strategies will have only a modest effect on population suicide rates, even if effective interventions are developed. Evaluating interventions for deliberate self-harm patients seems worthwhile. The UK Government's target for suicide reduction is more likely to be achieved using population-based strategies. Reducing the availability of methods commonly used for committing suicide is the most practicable current policy, although more radical approaches, for example reducing unemployment, may also substantially reduce suicide rates.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 4 , October 1997 , pp. 351 - 354
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Barraclough, B., Bunch, J., Nelson, B., et al (1974) One hundred cases of suicide. British Journal of Psychiatry, 125, 355–373.CrossRefGoogle Scholar
Chariton, J., Kelly, S., Dunnell, K., et al (1992) Trends in suicide deaths in England and Wales. Population Trends, 69, 10–16.Google Scholar
Dennehy, J. A., Appleby, L., Thomas, C. S., et al (1996) Case–control study of suicide by discharged psychiatric patients. British Medical Journal, 312, 1580.CrossRefGoogle ScholarPubMed
Freemantle, N., House, A., Song, F., et al (1994) Prescribing selective serotonin reuptake inhibitors as a strategy for prevention of suicide. British Medical Journal, 309, 249–253.CrossRefGoogle Scholar
Goldacre, M., Seagroatt, V. & Hawton, K. (1995) Suicide after discharge from psychiatric in-patient care. Lancet. 342, 283–286.CrossRefGoogle Scholar
Gunnell, D. & Frankel, S. (1994) Prevention of suicide: aspirations and evidence. British Medical purnal, 308, 1227–1233.CrossRefGoogle ScholarPubMed
Gunnell, D., Hawton, K., Murray, V., et al (1997) Use of paracetamol for suicide and non-fatal poisoning in the UK and France: are restrictions on availability justified? Journal of Epidemiology and Community Health, 57, 175–179.CrossRefGoogle Scholar
Hawton, K. (1997) Attempted suicide. In Cognitive Behaviour Therapy: Science and Practice (eds Clark, D. M. & Fairburn, C.). pp. 285–312. Oxford: Oxford University Press.Google Scholar
Hawton, K. & Fagg, J. (1988) Suicide, and other causes of death following attempted suicide. British Journal of Psychiatry, 152, 359–366.CrossRefGoogle ScholarPubMed
Hawton, K. & James, R. (1995) General hospital services for attempted suicide patients: a survey in one region. Health Trends. 27, 18–21.Google ScholarPubMed
Henry, J. A., Alexander, C. A. & Sener, E. K. (1995) Relative mortality from overdose of antidepressants. British Medical Journal, 310, 221–224.CrossRefGoogle ScholarPubMed
Jicck, S. J., Dean, A. D. & Jick, H. (1995) Antidepressants and suicide. British Medical Journal, 310, 215–281.CrossRefGoogle Scholar
Kelly, S., Charlton, J. & Jenkins, R. (1995) Suicide deaths in England and Wales, 1982–92: the contribution of occupation and geography. Population Trends, 80, 16–25.Google Scholar
Kreitman, N. (1976) The coal gas story: UK suicide rates 1960–1971. British Journal of Preventive and Social Medicine, 30, 86–93.Google Scholar
Last, J. M. (ed.) (1988) A Dictionary of Epidemiology (2nd edn). New York: Oxford University Press.Google Scholar
Lewis, G., Appleby, L. A. & Jarman, B. (1994) Suicide and psychiatric services. Lancet, 344, 822.CrossRefGoogle ScholarPubMed
Moser, K. A., Fox, A. J. & Jones, D. R. (1984) Unemployment and mortality in the OPCS Longitudinal Study. Lancet, ii, 1324–1328.CrossRefGoogle Scholar
Office of Population Censuses and Surveys (1993) 1991 Mortality Statistics. Cause. England and Wales. Series DH2 no. 18. London: HMSO.Google Scholar
Rose, G. (1992) The Strategy of Preventive Medicine. Oxford: Oxford University Press.Google Scholar
Rutz, W., von Knorring, L. & Walinder, J. (1989) Frequency of suicide on Gotland after systematic postgraduate education of general practitioners. Acta Psychiatrica Scandinavica, 80, 151–154.CrossRefGoogle ScholarPubMed
Sainsbury, P. (1986) The epidemiology of suicide. In Suicide (ed. Roy, A.), pp. 17–40. Baltimore. MD: Williams & Wilkins.Google Scholar
Secretary of State for Health (1992) The Health of the Nation: A Strategy for Health in England. London: HMSO.Google Scholar
Vassilas, C. A. & Morgan, H. G. (1993) General practitioners' contact with victims of suicide. British Medical Journal, 307, 300–301.CrossRefGoogle Scholar
Warr, P. (1987) Work. Unemployment and Mental Health. Oxford: Oxford Science Publications.Google Scholar
Wonderling, D., Langham, S., Buxton, M., et al (1996) What can be concluded from the Oxcheck and British family heart studies: commentary on cost-effectiveness analyses. British Journal of Psychiatry, 163, 111–112.Google Scholar
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