The International Handbook of Suicide Prevention: Research, Policy and Practice

By Rory C. O’Connor; Jane Pirkis | Go to book overview

36
Reducing Suicide Without
Affecting Underlying
Mental Health
Theoretical Underpinnings and a Review
of the Evidence Base Linking the Availability
of Lethal Means and Suicide

Deborah Azrael and Matthew J. Miller


Introduction

Worldwide, over 800,000 people die annually by suicide, approximately three out of ten as the result of intentional pesticide ingestion, a toll that has led the World Health Organization (2014) to call efforts to lower suicide rates “a global imperative.” Few suicide prevention interventions have been found to have an evidentiary base to achieve this goal; one that has is reducing access to highly lethal means used in suicides, often referred to as means restriction (Mann et al., 2005). Means restriction is now commonly seen as a vital component of any effective national strategy for reducing suicide rates. In the United States, for example, the 2012 National Strategy for Suicide Prevention, notes that reducing access to lethal suicide methods is “a proven strategy for decreasing suicide rates” (Office of the Surgeon General [US]; National Action Alliance for Suicide Prevention, 2012, p. 43), while the World Health Organization (2014, p. 9) notes succinctly that “restricting access to the means for suicide works.” Despite widespread endorsement by the public health community, and an increasingly compelling evidentiary base, interventions to reduce access to lethal means remain uncommon in many parts of the world (e.g., rural China, the United States), perhaps because little guidance exists as to how to implement these efforts or as to where and under what conditions any such intervention is most likely to be effective.

In this chapter, we provide a synthesis of the empirical literature that assesses the relationship between ready access to highly lethal means of suicide and overall suicide rates. We begin by laying out the theoretical underpinnings of the assertion that reducing access to lethal means of suicide can reduce suicide rates. Next, we

The International Handbook of Suicide Prevention, Second Edition. Edited by Rory C. O’Connor and Jane Pirkis. © 2016 John Wiley & Sons, Ltd. Published 2016 by John Wiley & Sons, Ltd.

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