AIMS AND OBJECTIVES
Suicide is the most serious outcome of a wide variety of mental illnesses, including depression, bipolar disorder, schizophrenia, eating disorders and substance abuse. Several recent milestones highlight the increasing international recognition of the global importance of suicide to health: in 2010 the World Health Organization’s (WHO) Mental Health Gap Action Programme to promote mental health in non-specialized health settings included suicide prevention as one of its main targets; in 2013 the first global mental health plan approved by all WHO member countries, the Global Mental Health Action Plan, included the goal of reducing suicide mortality by 10% by 2020.
The most important risk factor for death by suicide is having made a prior suicide attempt, so monitoring attempted suicides and reducing repeated suicidal behavior in this high-risk group of individuals is a fundamental part of the global effort to reduce suicide mortality. A recent meta analysis comparing different interventions to prevent repeated suicidal behavior in individuals who have made a recent suicide attempt concluded that ‘active contact and follow-up’ approaches are effective in reducing recidivism while other common interventions such as psychotherapy and pharmacotherapy are not effective. However, most of these ‘active contact and follow-up’ interventions have been conducted in high-income settings where mental health professionals are readily available, so they are of limited usefulness in low-resource setting.