SUICIDE-PREVENTION FROM A PUBLIC-HEALTH PERSPECTIVE

The public health approach to health problems provides a strong framew ork and rationale for developing and implementing suicide prevention p rograms. This approach consists of health-event surveillance to descri be the problem, epidemiologic analysis to identify risk factors, the d esign and evaluation of interventions, and the implementation of preve ntion programs. The application of each of these components to suicide prevention is reviewed. Suggestions for improving surveillance includ e encouraging the use of appropriate coding, reviewing suicide statist ics at the local level, collecting more etiologically useful informati on, and placing greater emphasis on analysis of morbidity data. For ep idemiologic analysis, greater use could be made of observational studi es, and uniform definitions and measures should be developed and adopt ed. Efforts to develop interventions must include evaluating both the process and the outcome. Finally, community suicide prevention program s should include more than one strategy and, where appropriate, should be strongly linked with the community's mental health resources. With adequate planning, coordination, and resources, and the public health approach can help reduce the emotional and economic costs imposed on society by suicide and suicidal behavior.