Sustainability Over Time

    Topic Progress:

    In order to pursue key objectives, long-term sustainability is crucial. For instance, identifying suicide-attempt or self-harm patients with a risk of long-term repetition, and their characteristics, requires data on consecutive cases of hospital-presented suicide attempts and self-harm over at least several years. Since attempted suicide and self-harm are associated with high levels of morbidity and mortality by suicide and other causes of premature death, sustaining suicide attempt and self-harm surveillance as a routine health information system should be a key priority. This priority should be endorsed and supported financially by national governments and ministries of health, and should ideally be incorporated into a national suicide prevention strategy or integrated into other surveillance efforts (e.g. on mental health, non-communicable diseases or injuries).

    In most countries, annual suicide mortality data from national statistics offices are published 2−3 years after the relevant year. Consequently, access to real-time surveillance data on hospital-presented suicide attempts and self-harm may be helpful in informing and evaluating interventions. In view of the consistency between trends in suicide attempts, self-harm and suicide among males, as observed in Ireland and other countries, data on suicide attempts and self-harm in males can be used as a proxy for suicide. This is a major advantage of these data and represents a convincing argument for funders and policy-makers in the area of suicide prevention.

    In countries with large geographical areas, where support and funding are available to expand the surveillance system but where regular meetings with the surveillance management team are not feasible, virtual meetings can be organized and wider implementation and sustainability can be achieved by using a “train-the-trainer” model.

    Optimizing the use of information obtained from the surveillance system (e.g. evidence briefs for government and policy makers on topics such as new methods of self-harm or clustering) can generate improved understanding regarding the importance of long-term surveillance of suicide attempts and self-harm.