Suicide Prevention Program: Suicide Prevention Across the Lifespan in Low-and Middle-Income Countries

Overview

Suicide is a significant global public health problem and a major contributor to the global burden of disease and mortality. Nearly 800,000 people die by suicide each year, with a global age-standardized suicide rate of 10.5 per 100,000.

It is estimated that 79% of the world’s suicides occur in Low-and, Middle-Income Countries (LMICs), where 80% of the world’s population lives. The overall suicide rate in LMICs might be higher than estimated since many LMICs lack a national suicide surveillance system and a systematic reporting system. Globally, interventions and strategies are designed to target individuals who have attempted suicide, but very few strategies target people for early identification and prevention interventions.

There is a need to develop culturally-adapted preventive strategies at the individual and population level for people across the lifespan in LMICs, focusing on multiple risks and protective factors across community settings, such as primary care, education, employment, social welfare, and justice settings.

This program:

• Supports research to address the gaps in our knowledge about suicide risk, protective factors, and preventive strategies across the lifespan in LMICs and strengthen and sustain local research capacity.
• Supports statistical and mathematical modeling to strengthen suicide surveillance and promote early identification.
• Aims to improve or implement surveillance systems on suicide ideation and behavior, suicide deaths, and treatment outcomes, promoting linkage to care and monitoring suicides and suicide attempts.
• Encourages early identification and preventive approaches that apply innovative mHealth technology and consider key stakeholders’ perspectives and system-level factors.
• Supports effectiveness and implementation of preventive interventions and strategies to reduce suicide risk, suicide ideation, and behavior, including acts of self-harm, and promote resilience.
• Supports testing and implementing strategies focusing on behavioral economics, financing models, policy/regulations, and social and economic interventions.
• Encourages economic analyses to adopt new best practices or inform policy.

Areas of Emphasis

• Studies that aim to improve and implement surveillance systems to monitor suicides and suicide attempts in the context of the research study.
• Research on the use of social media and search engine data to strengthen suicide surveillance and evaluate the impact of social media on suicide behaviors.
• Research on delivery, access, and effectiveness of preventive interventions that consider mechanisms of culturally relevant risk and resilience factors, including social determinants of health and comorbid factors related to alcohol and drug use.
• Studies to refine and test scalable and sustainable preventive interventions and strategies to implement and disseminate effective suicide prevention programs.
• Research models and strategies to integrate suicide screening for suicide ideation and behavior prevention and treatment into existing healthcare and community-level platforms.
• Research focuses on universal preventive strategies such as: restricting access to lethal means; promoting effective mental health policies and education through media and communication channels.
• Studies that test the impact of behavioral economic strategies, financing models, and policy/regulations (e.g., financing and reimbursement of health care and another service) on rates of suicide-related outcomes.
• Studies that test social and economic interventions and strategies (e.g., education and employment programs, income generation, and debt alleviation) to evaluate the impact of those interventions/strategies on rates of suicide-related outcomes.
• Research that evaluates the “return on investment,” preliminary cost-effectiveness, cost-benefit analysis, or other economic analyses used to implement suicide prevention care or optimize service organization/delivery facilitate decisions to adopt new best practices or inform policy.

Chief, Suicide Prevention Program
Andrea Horvath Marques MD, MPH, PhD
6001 Executive Boulevard
Rockville, MD 20852
andrea.horvathmarques@nih.gov