Crisis centers and their role in treatment: suicide prevention versus health promotion.

Suicide is a major health problem. In the industrialized nations, it remains among the 10 leading causes of death. There has been a massive effort to reduce suicide mortality through establishment of prevention centers. These centers have proliferated despite a lack of evidence concerning their efficacy. The development and evaluation of suicide prevention centers, primarily community-based, telephone interventions, are discussed. The evidence regarding the effectiveness of suicide prevention centers and the presence of a causal relationship between exposure to crisis counseling and a reduction in suicide rates is reviewed. Some cautions and recommendations are made. Finally, a model of health promotion program planning and evaluation is examined in the context of suicide prevention.