In line with the WHO report Preventing suicide: a global imperative (1), national surveillance of suicide and suicide attempts are considered a core element of national suicide prevention strategies. Countries currently initiating a national suicide prevention strategy may have a timely opportunity to propose simultaneous development and implementation of a national surveillance system, e.g. Bhutan where they are both implementing and developing their system.

Tip! In accordance with available resources, set up a steering committee, a technical advisory committee and a surveillance management team to develop and implement the surveillance system.

If resources are available, consider setting up the following groups:

1. A steering committee for the overall guidance and support of the surveillance system and the resources required. It should provide guidance to the technical advisory group and surveillance management team, and comprise of representatives of the Ministry of Health, Medicine, Emergency Medicine, Public Health, Psychiatry, Nursing, Suicide Prevention, Psychology, Health Information Systems and Biostatistics. An external advisor with expertise in developing and implementing similar surveillance systems may also be helpful.
2. A technical advisory group to provide guidance and technical inputs to the planning, implementation and evaluation of the system. This can be a relatively small group representing professionals from relevant disciplines at local level. Timelines for meetings should be determined depending on factors such as geographical coverage and population.
3. A surveillance management team to develop, implement and review the surveillance system consisting of a data collector and system manager according to available resources.

In many countries, it will not be feasible to have three distinct groups as described. In this case, the best fit for the context and the resources should be considered when drawing a group of experts or others.

While desirable to establish a national surveillance system from the outset, case examples of existing national or full coverage regional registries, such as in Ireland, Northern Ireland and Flanders (Belgium), show that full coverage was achieved by scaling up implementation from one geographic area to further areas. Increasing the scope of a regional register(s) to a national level might involve:

• increasing the size of the coordinating committee
• recruiting more members to the work-team
• improving training of the work-team
• strengthening or further organizing data collection, storage and analysis procedures