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19 Suicide prevention: need for an integrated approach
  1. G Gururaj
  1. Senior Professor and Head, Department of Epidemiology, WHO Collaborating Centre for Injury Prevention and Safety Promotion, Centre for Public Health, National Institute of Mental Health and Neuro Sciences, Bengaluru, India

Abstract

Suicide, hitherto a neglected public health problem, has been receiving greater attention in recent years due to growing increase and the accumulating evidence of its preventable nature. Nearly 800000 persons died due to a suicidal act in 2012 as per WHO. Low and Middle Income countries contributed to three fourths of global suicide with significant differences between countries. Age, gender and urban – rural differences are observed between and within countries in suicides.

The spectrum of suicides varies and includes those with suicides, suicidal attempts and suicidal ideations. For every suicide, nearly 10–20 attempt suicide and those with behaviours can only be a guestimate. Suicide is mainly due to a combination of presence of risk factors and absence of protective factors. These can be at an individual, family, societal and system related areas and encompass several biological, social, economic, cultural and environmental factors. The causative factors are often cumulative, repetitive, interactive and prolonged operating on a maladaptive platform.

Global experience has shown that suicides are predictable and preventable in nature. A strong national policy on suicide prevention and/or integrated into other sector’s policies and programmes is the need of the hour. Implementation of restricting access to means like control of easy availability of pesticides and drugs, alcohol control policies, positive media reporting, strengthening information systems are urgently required in many countries. Scaling up mental health services for availability and accessibility, destigmatization and decriminalisation will greatly support for reduction of suicides. Many new approaches and strategies are being implemented in several countries that need systematic evaluation.

However, many countries with high rates of suicide have very weak and fragmented policies/programmes along with a lack of good quality and robust data. Intersectoral approaches and skilled human and financial resources are often found lacking. The world Health assembly has set a global target of reducing suicides by 10% by 2020 and suicide prevention is included under Sustainable Development goals to be achieved by 2030. Achieving these goals and targets needs a strong commitment and enhanced suicide prevention efforts are much needed.

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