Development and implementation of a community-based suicide prevention program in primary care

Abstract

Background. Suicide is recognized as a public health issue in Malekan County through a health community assessment. A community-based suicide prevention program was conducted during 2014-2017. Methods. This health system research was conducted in seven steps, including conducting systematic reviews, gathering expert opinions, improving the coverage of suicide attempt records, conducting research to identify regional risk factors, conducting follow ups and managing the individuals attempting suicide, training health gatekeepers, and launching public awareness campaigns. Our goal was to lower the rates of suicide, and suicide attempt by 15% and 20%, respectively. Multiple logistic regression was calculated to estimate the adjusted odds ratios and the 95% confidence intervals. Result. 821 suicide attempts and 32 suicides had been recorded in the county. 70% of the suicides had been committed by men while the majority of attempters were females (64%). Most of the suicides (18cases-56.25%) had occurred in the spring while the majority of suicide attempts (288cases-35.8%) had been recorded in the summer. The common methods (62%) suiciders used were hanging and poisoning, which increased death risk significantly (OR: 8.5, 95% CI: 2.9–76.99). The incidence rates of suicide and suicide attempts reduced from 11.22, and 203 per 100,000 in 2013 to 2.63, and 157 in 2017, respectively. Suicide re-attempts also diminished from 12% in 2013 to 6.7% in 2017. Conclusion. Suicide, SA, and re-attempt were lowered by 75%, 22%, and 42%, respectively. Practical Implications. The practical framework that emerged out of the present study can be used for generating future suicide prevention strategies. Furthermore, our study highlights the need to consider a wide range of contextual factors when developing suicide prevention programs.

Effective suicide prevention strategies in primary healthcare settings: a systematic review

“…The fourth main component of suicide prevention strategies was managing suicide attempters. Azizi et al mentioned that follow-up monitoring of suicide attempters is one of the most effective and efficient strategies to reduce suicide and re-attempt rates in the population of their studies [3,7,15,41]. Findings indicated that the reattempt suicide rate is 16% during the first year of followup, 21% from the second to the fourth year, and 23% after the fourth year [42].…”

“…Although the majority of suicide mortality occurs in low-and middle-income countries, the majority of comprehensive suicide prevention programs have been developed in high-income countries [14]. It is vitally important to encourage and promote the development, implementation, and evaluation of suicide prevention strategies around the world, especially in the PHC settings [15]. Currently, suicide prevention strategies have been developed in medical settings [16].…”