[Reflecting on the 20th anniversary of the enactment of the Basic Act on Suicide Prevention: Measuring the actual numbers of suicide].

Objectives　The Basic Act on Suicide Prevention was enacted in 2006, and 2026 will mark the 20th anniversary of this act. To commemorate this milestone, a symposium titled "20th Anniversary of the Basic Act on Suicide Prevention: Understanding the Reality of Suicide" was held at the 83rd Annual Meeting of the Japanese Society of Public Health. The aim was to reflect on Japan's suicide prevention efforts to date through collaboration with experts.Methods: To accelerate suicide prevention efforts in Japan, we identified and organized the key challenges involved in understanding the reality of suicide.Results　Considering the history of suicide prevention, we carefully reviewed the issues surrounding the Basic Act on Suicide Prevention and the Act on the Promotion of Research and Studies on Suicide. We conclude that revisions are necessary where appropriate. It is also important to incorporate measures for cultivating specialized professionals across various fields into the Basic Act on Suicide Prevention that will be responsible for suicide prevention in the next generation, as well as mechanisms that enable suicide-bereaved families to participate in policymaking. In terms of statistical issues, there has been a significant "apparent change" in the suicide statistics between 2021 and 2022 due to the revision of original data, which requires careful attention. There is an upward trend in deaths from external causes, including suicide and deaths from unknown causes, and it is necessary to analyze these trends carefully. In addition, municipalities can use police statistics to understand the realities of regional suicides. However, when analyzing municipal-level data, it is important to consider the underlying processes that lead to self-harm and suicide attempts, using regional suicide profiles as a reference. In addition, conducting independent surveys and research at the municipal level, separate from national statistics, is crucial for suicide prevention.Conclusion　Suicide-related behavior is a complex issue influenced by various factors. It is essential to coordinate national measures with local initiatives. The following proposals are suggested to enhance future suicide prevention efforts:1. A review of the legal frameworks and establishment of support systems involving diverse stakeholders.2. Training of specialized personnel, including bereaved families, in the policymaking process.3. Conducting a thorough analysis of the statistical changes.4. Encouraging independent research and studies at the municipal level.By continuously updating our knowledge and fostering interdisciplinary discussions, we aim to ensure that these efforts are effectively implemented.