BMJ 1994;308:1227-1233 (7 May)
Education and debate
Prevention of suicide: aspirations and evidence
D Gunnell,
S Frankel
Health Care Evaluation Unit, Department of Epidemiology and Public Health Medicine, Bristol BS8 2PR Correspondence to: Dr Gunnell.
The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at risk. No single intervention has been shown in a well conducted randomised controlled trial to reduce suicide. The greatest potential seems to arise from limiting the availability of methods. In particular it is likely that the introduction of the catalytic convertor will lead to reduced lethality of car exhausts and reductions in suicide using this method. General practitioner education programmes, the effectiveness of lithium and maintenance antidepressants, and limits on the quantity of medicines available over the counter or on prescription should all be evaluated. Particular high risk groups include people recently discharged from . . . [Full text of this article]

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