Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA; email:
ICF, New York, NY, USA; email:
Annu Rev Clin Psychol. 2023 May 9;19:261-275. doi: 10.1146/annurev-clinpsy-080921-082634. Epub 2023 Jan 30.
The Garrett Lee Smith (GLS) Memorial Act, continuously funded since 2004, has supported comprehensive, community-based youth suicide prevention efforts throughout the United States. Compared to matched communities, communities implementing GLS suicide prevention activities have lower population rates of suicide attempts and lower mortality among young people. Positive outcomes have been more pronounced with continuous years of implementation and in less densely populated communities. Cost analyses indicate that implementation of GLS suicide prevention activities more than pays for itself in reduced health care costs associated with fewer emergency department visits and hospitalizations. Although findings are encouraging, the heterogeneity of community suicide prevention programs and the lack of randomized trials preclude definitive determination of causal effects associated with GLS. The GLS initiative has never been brought fully to scale (e.g., simultaneously impacting all communities in the United States), so beneficial effects on nationwide suicide rates have not been realized.
加勒特·李·史密斯纪念法案（GLS 法案）自 2004 年以来持续获得资金支持，为全美范围的综合性社区青年自杀预防工作提供了支持。与匹配社区相比，实施 GLS 自杀预防活动的社区自杀未遂率和年轻人死亡率较低。在持续多年实施和人口密度较低的社区中，积极结果更为明显。成本分析表明，GLS 自杀预防活动的实施通过减少与急诊就诊和住院相关的医疗保健费用，其成本大大超过了本身的费用。尽管研究结果令人鼓舞，但由于社区自杀预防计划的异质性和缺乏随机试验，无法确定与 GLS 相关的因果效应。GLS 计划从未全面实施（例如，同时影响美国所有社区），因此没有实现对全国自杀率的有益影响。
