There is now a substantial literature on risk factors for suicide in the United States (U.S. Dept of Health and Human Services, PHS, 2001; Committee on Pathophysiology & Prevention of Adolescent & Adult Suicide Board, 2002) that can be used to guide the development of prevention programs to reduce the rates of suicide in this country. There is a wealth of evidence that having a mental disorder increases the risk for both attempted suicide and suicide. However, in and of itself a mental disorder should not be equated with elevated suicide risk because the majority of individuals with a mental illness never kill themselves (Bostwick & Pankratz, 2000). Suicide is the outcome of extremely complex circumstances, and it is likely we will never be able to predict its occurrence given the putative interaction between psychiatric, psychological, physiological, social, and cultural factors. For example, there is considerable evidence that aggression and impulsivity, acute and chronic stress, trauma, and substance or alcohol use are associated with suicidality, but their effects are moderated by gender and age.
This chapter begins by reviewing a typology of strategies for suicide prevention; within this typology, four theoretical domains are used as a framework for describing existing interventions. Extant interventions for suicide are then examined for published evidence of effi cacy or effectiveness; interventions with demonstrable or promising evidence of effi cacy or effectiveness are discussed in detail. Finally, implications and limitations for public health practice and future prevention planning and the overall gaps in the research on suicide prevention are presented.
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References
Arias, E., Anderson, R. N., & Kung, H. C. (2003). Deaths: Final data for 2001. National Vital Statistics Reports (CDC), 52, 1–116
Aseltine, R. H. (2003). An evaluation of a school-based suicide prevention program. Adolescent & Family Health, 3, 81–88
Aseltine, R. H., & DeMartino, R. (2004). An outcome evaluation of the SOS Suicide Prevention Program. American Journal of Public Health 94 (3), 446–451
Barrios, L. C., Everett, S. A., Simon, T. R., & Brenner, N. D. (2000). Suicide prevention among US college students. Association with other injury risk behaviors. Journal of American College Health, 48, 229–233
Beautrais, A. L., Joyce, P. R., & Mulder, R. T. (1997). Precipitating factors and life events in serious suicide attempts among youths aged 13 through 24 years. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1543–1551
Beck, A. T., Kovacs, M., & Weissman, A. (1975). Hopelessness and suicidal behavior. An overview. Journal of the American Medical Association, 234, 1146–1149
Bostwick, J. M., & Pankratz, V. S. (2000). Affective disorders and suicide risk: A reexamination. The American Journal of Psychiatry, 157, 1925–1932
Brent, D. A., Johnson, B. A., Perper, J., Connolly, J., Bridge, J., Bartle, S., & Rather, C. (1994). Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 33, 1080–1086
Brown, C. H. (2003). Design principles and their application in preventive field trials. In W. J. Bukoski & Z. Sloboda (Eds.), Handbook of drug abuse theory, science, and practice (pp. 523–540). New York: Plenum Press
Brown, C. H., & Liao, J. (1999). Principles for designing randomized preventive trials in mental health: An emerging developmental epidemiology paradigm. American Journal of Community Psychology, 27, 673–710
Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts. Journal of the American Medical Association, 294, 563–570
Bruce, M., & Pearson, J. (1999). Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial). Dialogues in Clinical Neuroscience, 1, 100–112
Bruce, M. L., Ten Have, T. R., Reynolds, C. F. Ill, Katz, I. I., Schulberg, H. C., Mulsant, B. H., Brown, G. K., McAray, G. J., Pearson, J. L., & Alexopoulos, G. S. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: A randomized controlled trial. Journal of the American Medical Association, 291, 1081–1091
Cantor, C., & Neulinger, K. (1998). The epidemiology of suicide and attempted suicide among young Australians. Australian & New Zealand Journal of Psychiatry, 34, 8–14
Centers for Disease Control and Prevention. (1994). Programs for the prevention of suicide among adolescents and young adults; and suicide contagion and the reporting of suicide: Recommendations from a national workshop. Morbidity & Mortality Weekly Report, 40, 633–635
Chambers, D., Pearson, J., Lubell, K., Brandon, S., O’Brien, K., & Zinn, J. (2004). The science of public messages for suicide prevention: A workshop summary. Suicide & Life-Threatening Behavior, 35 (2), 134–145
Charney, D. S., Reynolds, C. F. III, Lewis, L., Lebowitz, B. D., Sunderland, T., Alexopoulos, G. S., Blazer, D. G., Katz, I. R., Meyers, B. S., Arean, P. A., Borson, S., Brown, C., Bruce, M. L., Callahan, C. M., Charlson, M. E., Conwell, Y., Cuthbert, B. N., Devanand, D. P., Gibson, M. J., Gottlieb, G. L., Krishnan, K. R., Laden, S. K., Lyketsos, C. G., Mulsant, B. H., Niederehe, G., Olin, J. T., Oslin, D. W., Pearson, J., Persky, T., Pollock, B. G., Raetzman, S., Reynolds, M., Salzman, C., Schulz, R., Schwenk, T. L., Scolnick, E., Unutzer, J., Weissman, M. M., & Young, R. C. (2003). Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Archives of General Psychiatry, 60, 664–672
Committee on Pathophysiology & Prevention of Adolescent & Adult Suicide Board on Neuroscience and Behavioral, Institute of Medicine (2002). Reducing suicide: A national imperative. Washington, D.C.: National Academy Press
Conner, K. R., Cox, C., Duberstein, P. R., Tian, L., Nisbet, P. A., & Conwell, Y. (2000a). Violence, alcohol, and completed suicide: A case-control study. American Journal of Psychiatry, 158, 1701–1705
Conner, K. R., Duberstein, P. R., & Conwell, Y. (2000b). Domestic violence, separation, and suicide in young men with early onset alcoholism: Reanalyses of Murphy’s data. Suicide & Life-Threatening Behavior., 30, 354–359
Conner, K. R., Li, Y., Meldrum, S., Duberstein, P. R., & Conwell, Y. (2003). The role of drinking in suicidal ideation: Analyses of Project MATCH data. Journal of Studies on Alcohol, 64, 402–408
Conwell, Y., & Duberstein, P. R. (2001). Suicide in elders. Annals of the New York Academy of Sciences, 932, 132–150
Conwell, Y., & Lyness, J. M., Duberstein, P., Cox, C., Seidlitz, L., DiGiorgio, A., & Caine, E. D. (2000). Completed suicide among older patients in primary care practices: A controlled study. Journal of the American Geriatrics Society, 48, 23–29
DeLeo, D., Buono, M. D., & Dwyer, J. (2002). Suicide among the elderly: The long-term impact of a telephone support and assessment intervention in northern Italy. British Journal of Psychiatry, 181, 226–229
DeLeo, D., Carollo, G., &Buono, M. D. (1995). Lower suicide rates associated with a tele-help/tele-check service for the elderly at home. American Journal of Psychiatry, 152, 632–634
Des Jarlais, D. J., & Friedman, S. R. (1998). Fifteen years of research on preventing HIV infection among injecting drug users: What we have learned, what we have not learned, what we have done, what we have not done. Public Health Reports, 113 (suppl. 1), 182–188
Dolan, L. J., Kellam, S. G., Brown, C. H., & Werthamer-Larsson, L. (1993). The short-term impact of two classroom-based preventive interventions on aggressive and shy behaviors and poor achievement. Journal of Applied Developmental Psychology, 14, 182–188
Douglas, K. A., & Collins, J. L. (1997). Results from the 1995 National College Health Risk Behavior Survey. Journal of American College Health, 46 (2), 55–66
Eggert, L. L., Thompson, E. A., Randell, B. P., & Pike, K. C. (2002). Preliminary effects of brief school-based prevention approaches for reducing youth suicide—Risk behaviors, depression, and drug involvement. Journal of Child & Adolescent Psychiatric Nursing, 15, 48–64
Etzersdorfer, E., Sonneck, G., & Nagel-Kuess, S. (1992). Newspaper reports and suicide. New England Journal of Medicine, 327, 502–503
Goss, R. J., Peterson, K., Smith, L. W., Kalb, K., & Brodey, B. B. (2002). Characteristics of suicide attempts in a large urban jail system with an established suicide prevention program. Psychiatric Services, 53, 574–579
Gould, M. S. (2001). Suicide and the media. Annals of the New York Academy of Sciences, 932, 200–224
Gould, M. S., Greenberg, T., Velting, D. M., & Shaffer, D. (2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 386–405
Gould, M. S., Fisher, P., Parides, M., Flory, M., & Shaffer, D. (1996). Psychosocial risk factors of child and adolescent completed suicide. Archives of General Psychiatry, 53, 1155–1162
Gould, M., Jamieson, P., & Romer, D. (2003). Media contagion and suicide among the young. American Behavioral Scientist, 46, 1269–1284
Gould, M. S., & Kramer, R. A. (2001). Youth prevention suicide. Suicide & Life-Threatening Behavior, 31, 6–31
Gould, M. S., Marrocco, F. A., Kleinman M., Thomas, J. G., Mostkoff, K., Cote, J., & Davies, M. (2005). Evaluating iatrogenic risk of youth suicide screening programs. A randomized trial. Journal of the American Medical Association, 293 (13), 1635–1643
Gunnell, D., Lopatatzidis, A., Dorling, D., Wehner, H., Southall, H., & Frankel, S. (1999). Suicide and unemployment in young people. Analysis of trends in England and Wales, 1921–1995. British Journal of Psychiatry, 175, 263–270
Guthrie, E., Kapur, N., Mackway-Jones, K., Chew-Graham, C., Moorey, J., Mendel, E., Marino-Francis, F., Sanderson, S., Turpin, C., Boddy, G., & Tomenson, B. (2001). Randomised controlled trial of brief psychological intervention after deliberate self poisoning. British Medical Journal, 323, 135–138
Hawton, K. (2002). United Kingdom legislation on pack sizes of analgesics: Background, rationale, and effects on suicide and deliberate self-harm. Suicide & Life-Threatening Behavior, 32, 223–229
Hawton, K., Ware, C., Mistry, H., Hewitt, J., Kingsbury, S., Roberts, D., & Weitzel, S. (1996). Paracetamol self-poisoning: Characteristics, prevention and harm reduction. British Journal of Psychiatry, 168, 43–48
Ho, T. P., Hung, S. F., Lee, C. C., Chung, K. F., & Chung, S. Y. (1995). Characteristics of youth suicide in Hong Kong. Social Psychiatry & Psychiatric Epidemiology, 30 (3), 107–112
Hutchinson, G., Daisley, H., Simeon, D., Simmonds, V., Shetty, M., & Lynn, D. I. (1999). High rates of paraquat-induced suicide in southern Trinidad. Suicide & Life-Threatening Behavior, 29, 186–191
Jobes, D. A., Jacoby, A. M., Cimbolic, P., & Hustead, L. A. (1997). Assessment and treatment of suicidal clients in a university counseling center. Journal of Counseling Psychology, 44 (4), 368–377
Joe, S., & Kaplan, M. (2001). Suicide among African American men. Suicide & Life-Threatening Behavior, 31, 106–121
Joiner, T. E. Jr., Pfaff, J. J., & Acres, J. G. (2002). A brief screening tool for suicidal symptoms in adolescents and young adults in general health settings: Reliability and validity data from the Australian National General Practice Youth Suicide Prevention Project. Behaviour Research & Therapy, 40, 471–481
Kalafat, J., & Elias, M. (1994). An evaluation of a school-based suicide awareness intervention. Suicide & Life-Threatening Behavior, 24, 224–233
Kellam, S. G., & Langevin, D. (2003). A framework for understanding “evidence” in prevention research and programs. Prevention Science, 4, 137–153
Kelly, J. A., Lawrence, S., & Diaz, Y. E. (1991). HIV risk behavior reduction following intervention with key opinion leaders of population: An experimental analysis. American Journal of Public Health, 81, 168–171
King, K. S. J. (2000). Project SOAR: A training program to increase school counselors’ knowledge and confidence regarding suicide prevention and intervention. Journal of School Health, 70, 402–407
Knox, K. L., Litts, D. A., Talcott, G. W., Feig, J. C., & Caine, E. D. (2003). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the United States Air Force: Cohort study. British Medical Journal, 327, 1376–1380
Knox, K. L., & Caine, E. D. (2005). Establishing priorities for reducing suicide and its antecedents in the United States. American Journal of Public Health, 95 (11), 1898–1903
Kochanek, K. D., & Smith, B. L. (2004). Deaths: Preliminary data for 2002 (Report No. 52[13]). National Vital Statistics Reports, pp. 1–48
Kruesi, M.J. P., Grossman, J., Pennington J. M., Woodward, P., Duda, D., & Hirsch, J. G. (1999). Suicide and violence prevention: Parent education in the emergency department. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 250–255
LaFromboise, T. D. (1995). The Zuni Life Skills Development Curriculum: Description and evaluation of a suicide prevention program. Journal of Counseling Psychology, 42, 479–486
Lamberti, S. J., & Weisman, R. L. (2002). Preventing incarceration of adults with severe mental illness: Project Link. In G. Landsberg, M. Rock, & L. Berg (Eds.), Seriously mentally ill offenders. (pp. 133–143). New York: Springer
Lamberti, J. S., Weisman, R. L., Schwarzkopf, S. B., Price, N., Ashton, R. M., & Trompeter, J. (2001). The mentally ill in jails and prisons: Towards an integrated model of prevention. Psychiatric Quarterly, 72, 63–77
Langhinrichsen-Rohling, J., Arata, C., Bowers, D., O’Brien, N., & Morgan, A. (2004). Suicidal behavior, negative affect, gender, and self-reported delinquency in college students. Suicide & Life-Threatening Behavior, 34, 255–266
Latkin, C. A., & Forman, V. L. (2001). Patterns of needle acquisition and sociobehavioral correlates of needle exchange program attendance in Baltimore, Maryland, U.S.A. Journal of Acquired Immune Deficiency Syndromes, 27, 398–404
LeMaster, P. L., & Connell, C. M. (1994). Health education interventions among Native Americans: A review and analysis. Health Education Quarterly, 21, 521–538
Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064
Litts, D. A., Moe, K., Roadman, C. H., Miller, J., &Janke, R. (1999). Suicide prevention among active duty air force personnel—United States 1990–1999. Morbidity & Mortality Weekly Report, 48, 1053–1057
Luoma, J. B., & Pearson, J. L. (2002). Suicide and marital status in the United States, 1991–1996: Is widowhood a risk factor? American Journal of Public Health, 92, 1518–1522
Mann, J. J., Huang, Y. Y., Underwood, M. D., Kassir, S. A., Oppenheim, S., Kelly, T., Dwork, A. J., & Arango, V. (2000). A serotonin transporter gene promoter polhymorphism (5-HTTLPR) and prefrontal cortical binding in major depression and suicide. Archives of General Psychiatry, 57, 729–738
Mehlum, L., & Reinholdt, N. (2000). The Norwegian plan for suicide prevention: Follow-up project 2000–2002; Building on positive experiences. Notwegian Journal of Suicidologi, 5, Supplement
Metha, A., Weber, B., & Webb, L. D. (1998). Youth suicide prevention: A survey and analysis of policies and efforts in the 50 states. Suicide & Life-Threatening Behavior, 28, 150–164
Middlebrook, D. L., LeMaster, P. L., Beals, J., Novins, D. K., & Manson, S. M. (2001). Suicide prevention in American Indian and Alaska Native communities: A critical review of programs. Suicide & Life-Threatening Behavior, 31, 132–149
Motto, J. A., & Bostrom, A. G. (2001). A randomized controlled trial of postcrisis suicide prevention. Psychiatric Services, 52, 828–833
Mrazek, P. J., & Haggerty, R.J. (1994). Risk and protective factors for the onset of mental disorders. In Reducing risks for mental disorders: Frontiers for preventive intervention research (pp. 127–214). Washington, DC: National Academy Press
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. (2005). Non-fatal self injury data for 2003. Retrieved July 10, 2005, from http://www.cdc.gov/ncipc/wisqars/default.htm; accessed
Orbach, I., & Bar-Joseph, H. (1993). The impact of a suicide prevention program for adolescents on suicidal tendencies, hopelessness, ego identity, and coping. Suicide & Life-Threatening Behavior, 23, 120–129
Palmer, C. S., Revicki, D. A., Halpern, M. T., & Hatziandreu, E. J. (1995). The cost of suicide and suicide attempts in the United States. Clinical Neuropharmacology, 18, S25–S53
Pearson, J. L., Stanley, B., King, C., & Fisher, C. (2001). Issues to consider in intervention research with persons at high risk for suicidality. Washington, D.C.: National Institute of Mental Health
Pearson, J. L., & Brown, G. K. (2000). Suicide prevention in late life: Directions for science and practice. Clinical Psychology Review, 20, 685–705
Pearson, J. L., Conwell, Y., & Lyness, J. M. (1997). Late-life suicide and depression in the primary care setting. In L. S. Schneider (Ed.), Developments in geriatric psychiatry: New directions for mental health services, (pp. 13–38, vol. 76). San Francisco: Jossey-Bass
Pena, J. B., & Caine, E. D. (2005). Screening as an approach for adolescent suicide prevention. Paper presented at the Suicide Prevention Resource Center Regional Conference, Pittsburgh, PA
Shaffer, D., Vieland, V., Garland, A., Rojas, M., Underwood, M. M., & Busner, C. (1990). Adolescent suicide attempters: Response to suicide-prevention programs. Journal of the American Medical Association, 264, 3151–3155
Shaffer, D., Gould, M., & Hicks, R. C. (1994). Worsening suicide rate in black teenagers. American Journal of Psychiatry, 151, 1810–1812
Shaffer, D., Scott, M., Wilcox, H., Maslow, C., Lucas, C., Garfinkel, R., & Greenwald, S. (2004). The Columbia Suicide Screen: Validity and reliability of a screen for youth suicide and depression. The Journal of the American Academy of Child & Adolescent Psychiatry, 43, 71–79
Thompson, E. A., Eggert, L. L., Randell, B. P., & Pike, K. C. (2001). Evaluation of indicated suicide risk prevention approaches for potential high school dropouts. American Journal of Public Health, 91, 742–752
Tuskan, J. J., & Thase, M. E. (1983). Suicides in jails and prisons. Journal of Psychosocial Nursing & Mental Health Services, 21, 29–33
U.S. Department of Health and Human Services, Public Health Service (2001). National Strategy for Suicide Prevention: Goals and Objectives for Action. Rockville, MD: Author
Weisman, R. L., & Lamberti, J. S. (2002). Violence prevention and safety training for case management services. Community Mental Health Journal, 38, 339–348
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Knox, K.L. (2008). Interventions to Prevent Suicidal Behavior. In: Doll, L.S., Bonzo, S.E., Sleet, D.A., Mercy, J.A. (eds) Handbook of Injury and Violence Prevention. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-29457-5_10
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