US Department of Health and Human Services, Public Health Services. (Pp 204, free: 1-800-789-2647: reference document # SMA 3517), 2001. 02NLM:HV 6548.A1 2001 or see: http://www.surgeongeneral.gov/library.

In 1999, the publication of Kay Redfield Jamison's Night Falls Fast (see Injury Prevention, December 2000;6:312) catalyzed national reassessment of suicide causes, prevention, and control in the USA. The book encouraged researchers to help find more and effective ways to prevent suicides and provided a base for institutionalization on suicide prevention.

A National Strategy for Suicide Prevention: Goals and Objectives for Action is the result of a process led by the US Surgeon General. Establishing a National Council for Suicide Prevention made up of not-for-profit organizations and linking a half dozen federal agencies already concerned with suicide. A central part of the process was community involvement which was assisted by public hearings with testimony (including my own). The key elements of a planned national strategy offer a model for the on going dialectic of injury prevention and control planning, development, organizing, initiation, and evaluation.

A mild criticism of Night Falls Fast was that it could have had a more extensive chapter on public heath, this is overcome in the National Strategy. A comprehensive public health approach to prevention is tied to essential mental health principles and practices. Goals and objectives are outlined within the framework of UN/WHO guidelines, with short examples of initiatives in other countries.

The goals focus on awareness, intervention, and methodology. From promoting awareness that suicides are a public health problem that is preventable to improving surveillance systems, the goals and objectives offer a tapestry of ideas and approaches. The historical review is, unfortunately, too short an analysis for guidance on real life leadership dynamics. The final goals and objectives of the report are linked to national senior citizens groups, firearm safety design, but, not as yet, to national poison control systems just being enhanced in the USA. The appendices on evaluation of programs, on promising research efforts, of special populations at risk, and on a resource “bookshelf” are exceptional.

The new and promising venture represents a cross section of the national leadership expertise and institutional experiences in the USA. The report's hope is for some greater fiscal investments in programming and, all in all, comprehensively and effectively covers the full spectrum of an important National Strategy.