2019
DOI: 10.1017/s2045796019000659
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Building the foundation for comprehensive suicide prevention – based on intention and planning in a social–ecological context

Abstract: National suicide prevention programmes that have been successful in reducing rates or keeping them low have been intentional, with collective alignment of local, regional and national priorities. Prevention efforts must begin well before individuals become suicidal, complementing readily available clinical services that address the needs of acutely distressed persons. These efforts, which focus on the antecedent risks and vulnerabilities of key populations, have the potential to diminish premature mortality fr… Show more

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Cited by 18 publications
(11 citation statements)
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“…Public health solutions recognize that effective and efficient prevention begins long before a person experiences suicide‐related thoughts and behaviors. Public health approaches direct efforts at the full range of the socioecological context, seeking to create change in individuals, relationships, communities, and society (Caine, 2019). Public health systems include public health agencies, healthcare providers, social service organizations, youth service providers, funders, and environmental agencies, among others (CDC, 2018b).…”
mentioning
confidence: 99%
“…Public health solutions recognize that effective and efficient prevention begins long before a person experiences suicide‐related thoughts and behaviors. Public health approaches direct efforts at the full range of the socioecological context, seeking to create change in individuals, relationships, communities, and society (Caine, 2019). Public health systems include public health agencies, healthcare providers, social service organizations, youth service providers, funders, and environmental agencies, among others (CDC, 2018b).…”
mentioning
confidence: 99%
“… 2 Therefore, it is useful to consider how alignment might look in practice. Effective youth suicide prevention requires collective action and values 3 at all levels. 4 YouthLine, based in Portland, OR, USA, is one of the few teen support and crisis lines in the USA that uses youth volunteers ( appendix p 1 ).…”
mentioning
confidence: 99%
“…The SIM epidemic-including suicides and drug poisoning fatalities-will not be reversed merely by interventions nested within the healthcare system. SIM and suicide interventions must also address well-described upstream social determinants [3,4], and involve major and integrated structural and public policy changes throughout the economic, political, educational, policing and criminal justice, environmental protection, and healthcare systems. This study has several limitations.…”
Section: Discussionmentioning
confidence: 99%
“…Although highly conflated in reality [1][2], suicides and fatal drug overdoses in the United States (US) have been treated as distinct phenomena in the scientific literature, mass media coverage, and governmental funding priorities. When viewed through an ecological lens, many of these deaths arise from common adverse life circumstances and personal distress, and are the result of motivated behaviour, even as medical examiners and coroners (ME/CS), as well as family members and other survivors, seek to disentangle and define the intent of decedents' final moments [3,4]. Together with other colleagues, we have advocated the use of 'self-injury mortality' (SIM) to mitigate the uncertainties of injury manner of death determinations, while underscoring the collective public health importance of intervening long before people come to the 'edge of the ledge' [5,6].…”
Section: Introductionmentioning
confidence: 99%