What Are the Most Effective Secondary Suicide Prevention Strategies?
In a recent systematic review of suicide prevention strategies, Mann et al. [12], found evidence of effectiveness in five secondary suicide prevention methods: pharmacological interventions, psychological interventions, follow-up care, reduced access to lethal means, and responsible media reporting of suicide [12]. Antidepressant medications are the most widely used pharmacological interventions in secondary suicide prevention, but studies of their effectiveness in reducing suicide attempts and completed suicides have had mixed results [12]. For example, although population studies show a decrease in suicide rates in the 27 countries with the greatest increase in selective serotonin reuptake inhibitor (SSRI) prescription [27], in 2003 and 2004 US and European regulators issued warnings about a possible association between antidepressant use and suicidal thinking and behavior. Since then, a meta-analysis [28] of randomized controlled trials has suggested that SSRIs may increase suicide
