APSI: a proposed integrative model for suicide prevention.

Deaths by suicide have been increasing in recent years in Ireland, many of whom have co-morbid mental health difficulties and/or have attended primary care services 1 month before death. Aims To profile how 'Access to Psychological Services Ireland' (APSI) provides stepped-care therapies for mild-to-moderate adult mental health presentations and the potential effectiveness of this model based on comparison to a review of evidence-based strategies in suicide prevention. A secondary aim is to highlight how APSI has the potential to target those at risk of suicide and provide an integrative after-care service to complement secondary care mental health services. Findings In a context of inter-agency working, APSI provides an integrated continuum of suicide prevention interventions that map onto or intervene across the continuum of suicide behaviour. Hence, APSI appears to implement what the literature suggests will work in preventing suicide. However, outcome research is needed to establish APSI's impact in preventing suicide. Recommendations It is recommended that Irish-based research is conducted to establish APSI's impact in preventing suicide with a view to rolling out APSI as a national mental health clinical care programme.