EDITOR, - The prevention of suicide may be controversial, but does it really warrant the pessimism expressed recently? David Gunnell and Stephen Frankel provide a comprehensive review of the prevention of suicide, but their conclusions seem unduly negative.1 Jennie McCarthy and Ian Davidson rightly see problems with the use of suicide as an indicator for the performance of mental health services.2 However, “health of the nation outcome scales” to measure improvements in the health and social functioning of mentally in people should be available soon.

Suicide is an important cause of death (5542 suicides occurred in 1992, including death undetermined cause) and is more common that deaths from road traffic accidents (3814 occurred in 1992) and from cervical cancer (1532), yet the attention paid to it is far less. Perhaps it is still viewed as a choice that should not be constrained Yet most people who commit suicide are seriously depressed,3 believing that they have no or little choice …