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AN IMPLEMENTATION GUIDE FOR SUICIDE PREVENTION IN COUNTRIES LIVE LIFE An implementation guide for suicide prevention in countries Live life: an implementation guide for suicide prevention Third-party materials. If you wish to reuse material from this work in countries that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed ISBN 978-92-4-002662-9 (electronic version) for that reuse and to obtain permission from the copyright holder. ISBN 978-92-4-002663-6 (print version) The risk of claims resulting from infringement of any third-party- owned component in the work rests solely with the user. © World Health Organization 2021 General disclaimers. The designations employed and the Some rights reserved. This work is available under the Creative presentation of the material in this publication do not imply Commons Attribution-NonCommercial-ShareAlike 3.0 IGO the expression of any opinion whatsoever on the part of WHO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/ concerning the legal status of any country, territory, city or area licenses/by-nc-sa/3.0/igo). or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent Under the terms of this licence, you may copy, redistribute and approximate border lines for which there may not yet be full adapt the work for non-commercial purposes, provided the agreement. work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses The mention of specific companies or of certain manufacturers’ any specific organization, products or services. The use of the products does not imply that they are endorsed or WHO logo is not permitted. If you adapt the work, then you recommended by WHO in preference to others of a similar must license your work under the same or equivalent Creative nature that are not mentioned. Errors and omissions excepted, Commons licence. If you create a translation of this work, you the names of proprietary products are distinguished by initial should add the following disclaimer along with the suggested capital letters. citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or All reasonable precautions have been taken by WHO to verify accuracy of this translation. The original English edition shall be the information contained in this publication. However, the the binding and authentic edition”. published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the Any mediation relating to disputes arising under the licence interpretation and use of the material lies with the reader. In no shall be conducted in accordance with the mediation rules of the event shall WHO be liable for damages arising from its use. World Intellectual Property Organization (http://www.wipo.int/ amc/en/mediation/rules/). Credit for cover photos (in this order): WHO/Anna Karia, WHO/ Tom Pietrasik, WHO/Heehaw, WHO/Tom Pietrasik, WHO/Lianne Suggested citation. Live life: an implementation guide Gutcher, WHO/Lianne Gutcher, WHO/Anna Kari and WHO/ for suicide prevention in countries. Geneva: World Health Sergey Volkov Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO. Graphic design and layout: Kellie Hopley Design Ltd Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. CONTENTS Index of boxes iv Foreword vii Acknowledgements viii Executive summary x Introduction 1 PART A. LIVE LIFE CORE PILLARS 6 Situation analysis 7 Multisectoral collaboration 13 Awareness-raising and advocacy 25 Capacity-building 32 Financing 39 Surveillance 45 Monitoring and evaluation 53 PART B. LIVE LIFE: KEY EFFECTIVE INTERVENTIONS FOR SUICIDE PREVENTION 57 Limit access to the means of suicide 58 Interact with the media for responsible reporting of suicide 64 Foster socio-emotional life skills in adolescents 70 Early identify, assess, manage and follow up anyone who is affected by suicidal behaviours 75 Annex 1. Sectors and stakeholders in suicide prevention 81 Annex 2. Further examples from countries 82 Annex 3. LIVE LIFE indicators framework 104 Annex 4. Resources 110 References 121 LIVE LIFE | iii INDEX OF BOXES Box 1. Forming a Steering Committee and working groups 3 Box 2. Suicide prevention in emergencies 4 Box 3. A situation analysis of suicide prevention, Czechia 10 Box 4. National suicide study, Namibia 11 Box 5. Decriminalizing suicide, Ireland 14 Box 6. The influence of circumstances on multisectoral efforts to prevent suicide, Suriname 14 Box 7. Integrating suicide prevention into mental health and substance use policy, Lebanon 15 Box 8. Local adaptations for local implementation and priority populations 17 Box 9. How the government facilitated multisectoral cooperation, Bhutan 18 Box 10. Forming public-private partnerships, United States of America 19 Box 11. Influence at the highest level, Australia 20 Box 12. Including people with lived experience 20 Box 13. Saving lives, led by the community, India 22 Box 14. Presidential task force for suicide prevention, Sri Lanka 23 Box 15. Raising awareness creates demand for services, Kenya 26 Box 16. National suicide awareness month, Japan 26 Box 17. See Me – addressing stigma, Scotland 27 Box 18. Determined and committed champions, United States of America 28 Box 19. Turning grief into action against suicide, Iraq 29 Box 20. Scale-up of multisectoral gatekeeper training, Malaysia 33 Box 21. Capacity-building for judges, Ghana 34 Box 22. Strengthening the health workforce to prevent suicide, Guyana 36 Box 23. Building capacity for workplace suicide prevention, Australia 36 Box 24. Checklist: asking for funds from national and local regional budgets 40 Box 25. Philanthropists, Ghana 42 Box 26. National Suicide Prevention Trial, Australia 42 Box 27 Surveillance, Sri Lanka 47 Box 28. Self-harm surveillance, Russian Federation 48 Box 29. The self-harm and suicide registration system, Islamic Republic of Iran 50 Box 30. Surveillance, White Mountain Apache Tribe, USA 51 Box 31. Monitoring and evaluating a national suicide prevention strategy, Ireland 55 iv | LIVE LIFE INDEX OF BOXES Box 32. Ban on highly hazardous pesticides, Sri Lanka 59 Box 33. A story of success, Republic of Korea 62 Box 34. Media monitoring, Lithuania 64 Box 35. The Papageno-Media Prize, Austria 66 Box 36. Successes and challenges in engaging the media, Malaysia 67 Box 37. Media guidelines, Trinidad and Tobago 68 Box 38. World Health Organization’s Helping adolescents thrive (HAT) 71 Box 39. Evidence-based application for adolescent Aboriginal and Torres Strait Islander Australians, Australia 71 Box 40. Youth Aware of Mental Health (YAM), from research to implementation, Sweden 73 Box 41. Case management for people who have attempted suicide, Republic of Korea 75 Box 42. Aboriginal-specific aftercare, Australia 78 Box 43. Scaling up mental health services and suicide prevention, Islamic Republic of Iran 79 Box 44. Data analytics and insights system, Australia 82 Box 45. The national study of suicide, Iraq 83 Box 46. Situation analysis, Syrian Arab Republic 84 Box 47. An example of bottom-up multisectoral collaboration, Brazil 85 Box 48. Multisectoral collaboration, Canada 86 Box 49. Alcohol policy and legislation, Russian Federation 86 Box 50. Meaningful participation of people with lived experience in suicide prevention, Scotland 87 Box 51. Roses in the Ocean – an organization for those with lived experience of suicide, Australia 88 Box 52. Integrating an all-of-nation, whole-of-government approach, USA 89 Box 53. Suicide prevention and management, occupied Palestinian territory, including east Jerusalem 90 Box 54. Awareness-raising and advocacy, Canada 91 Box 55. World Mental Health Day and World Suicide Prevention Day 91 Box 56. LGBTIQ adaptation of evidence-based gatekeeper training, Australia 92 Box 57. Community gatekeeper training project, Canada 93 Box 58. Capacity-building, Islamic Republic of Iran 93 Box 59. IOM Mental Health and Psychosocial Support Programme: suicide prevention and response, Iraq 94 Box 60. Gatekeeper training evaluated, Netherlands 94 Box 61. Suicide prevention, Turkey 95 Box 62. The Queensland Suicide Register, Australia 96 LIVE LIFE | v INDEX OF BOXES Box 63. Surveillance of intentional injuries, Brazil 96 Box 64. Observatory of Suicidal Behaviour, Central America and the Dominican Republic 97 Box 65. The Aga Khan University Hospital Self-Harm Monitoring System (AKUH-SHMS), Pakistan 98 Box 66. Pesticide bans, Bangladesh 99 Box 67. Limiting access to means in the community, Canada 99 Box 68. Restricting access to pesticides, Fiji 100 Box 69. Banning paraquat, Malaysia 100 Box 70. Adaptation and implementation of guidelines for responsible media reporting on suicide, Slovenia 101 Box 71. Suicide bereavement group support facilitators network, Canada 102 Box 72. Following up people who have attempted suicide, Islamic Republic of Iran 102 Box 73. Recovery assistant as an emerging profession, Poland 103 vi | LIVE LIFE © WHO / NOOR / Arko Datto FOREWORD Any death by suicide is a deeply sad occasion. It is extremely painful for close family members and friends left behind who LIVE LIFE recognizes the role that both governments cannot understand why it happened. Inevitably, their sadness is and communities play in implementing actions for suicide multiplied as they ask themselves what they could have done to prevention. Currently, 38 countries are known to have a national prevent the untimely death. suicide prevention strategy. While a funded national suicide prevention strategy that includes LIVE LIFE interventions and There are more than 700 000 deaths by suicide worldwide every pillars remains the pinnacle of a government-led response year – each one a tragedy, with far-reaching impact on families, to suicide, the absence of such a strategy should not friends and communities.
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