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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  • Gaynes, B. N., West, S. L., Ford, C. A., Frame, P., Klein, J., Lohr, K. N. (2004). Screening for Suicide Risk in Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force. ANN INTERN MED 140: 822-835 [Abstract] [Full text]  
  • Horrocks, J., House, A., Owens, D. (2004). Establishing a clinical database for hospital attendances because of self-harm. Psychiatr. Bull. 28: 137-139 [Abstract] [Full text]  
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  • DE LEO, D. (2002). Why are we not getting any closer to preventing suicide?. Br. J. Psychiatry 181: 372-374 [Full text]  
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  • Frankel, S. (2001). Commentary: Medical care and the wider influences upon population health: a false dichotomy. Int J Epidemiol 30: 1267-1268 [Full text]  
  • Weir, E. (2001). Suicide: the hidden epidemic. CMAJ 165: 634-636 [Full text]  
  • Motto, J. A., Bostrom, A. G. (2001). A Randomized Controlled Trial of Postcrisis Suicide Prevention. Psychiatr. Serv. 52: 828-833 [Abstract] [Full text]  
  • EAGLES, J. M., KLEIN, S., GRAY, N. M., DEWAR, I. G., ALEXANDER, D. A. (2001). Role of psychiatrists in the prediction and prevention of suicide: a perspective from north-east Scotland. Br. J. Psychiatry 178: 494-496 [Full text]  
  • Welch, S. S. (2001). A Review of the Literature on the Epidemiology of Parasuicide in the General Population. Psychiatr. Serv. 52: 368-375 [Abstract] [Full text]  
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  • Neeleman, J (2001). A continuum of premature death. Meta-analysis of competing mortality in the psychosocially vulnerable. Int J Epidemiol 30: 154-162 [Abstract] [Full text]  
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  • HAWTON, K., CLEMENTS, A., SIMKIN, S., MALMBERG, A. (2000). Doctors who kill themselves: a study of the methods used for suicide. QJM 93: 351-357 [Abstract] [Full text]  
  • Deahl, M., Douglas, B., Turner, T. (2000). Full metal jacket or the emperor's new clothes?: The National Service Framework for Mental Health. Psychiatr. Bull. 24: 207-210 [Full text]  
  • Wintemute, G. J., Parham, C. A., Beaumont, J. J., Wright, M., Drake, C. (1999). Mortality among Recent Purchasers of Handguns. NEJM 341: 1583-1589 [Abstract] [Full text]  
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  • Cranney, M., Cranney, J., Stubbs, H., Jowett, N. I (1998). Limitation of over the counter sales of paracetamol. BMJ 317: 1657-1657 [Full text]  
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  • Hawton, K. (1998). A national target for reducing suicide. BMJ 317: 156-157 [Full text]  
  • Long, A., Long, A., Smyth, A. (1998). Suicide: a statement of suffering. Nurs Ethics 5: 3-15 [Abstract]  
  • Williams, E. R L, Meadows, J., Catal, J., Shevlin, M., Brunsden, V., Walker, S., Davies, M., Ramkalawan, T. (1997). Death of Diana, Princess of Wales. BMJ 315: 1467-1467 [Full text]  
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  • Whitfield, W., Southern, D. A. (1996). The prevention of suicide: some practical steps. The Journal of the Royal Society for the Promotion of Health 116: 295-297  
  • Hagen, S, Hall, D, Stark, C, Smith, H (1996). Admissions due to overdoses of aromatic analgesics have increased in Scotland. BMJ 312: 1538a-1538 [Full text]  
  • Thomas, S., Bevan, L., Bhattacharyya, S., Bramble, M., Chew, K., Connolly, J., Dorani, B., Han, K., Horner, J., Rodgers, A., Sen, B., Tesfayohannes, B., Wynne, H., Bateman, D. (1996). Presentation of poisoned patients to accident and emergency departments in the North of England. Hum Exp Toxicol 15: 466-470 [Abstract]  
  • McLoone, P. (1996). Suicide and deprivation in Scotland. BMJ 312: 543-544 [Full text]  
  • Stark, C., Hall, D., O'Brien, F., Smith, H. (1995). Suicide after discharge from psychiatric hospitals in Scotland. BMJ 311: 1368c-1369 [Full text]  
  • Gunnell, D. J, Peters, T. J, Kammerling, R. M, Brooks, J. (1995). Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation. BMJ 311: 226-230 [Abstract] [Full text]  
  • Gunnell, D. (1995). The two study groups may not be comparable. BMJ 311: 56a-56 [Full text]  
  • Kingdon, D, Warner, J, Stark, C, Smith, H, Hall, D, O'Brien, F (1994). Prevention of suicide Depressed patients need more choices. BMJ 309: 1088a-1088 [Full text]  
  • Davies, S, Buckley, A, Naik, P, Lee, A S (1994). Prevention of suicide. BMJ 309: 196b-197 [Full text]  
  • McCarthy, J, Davidson, I (1994). Suicide as an indicator of mental health. BMJ 309: 58b-58 [Full text]  

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