Suicide prevention: at what level does it work?

This paper reviews the prevention of suicide according to programme evaluation, risk and protective factors, type of intervention, level of intervention and the interface between clinical and public health levels. From nearly a century of experience, a few but important lessons have been learned: since suicide is affected by sociocultural factors, there is no safe indication that what has worked somewhere will work elsewhere; in order to acquire any public health importance, suicide prevention programmes must clearly spell out their objectives and targets; isolated actions have a much lesser probability of yielding significant population outcome results than more articulated approaches that integrate public health measures and individual care with appropriate follow-up and social support.