Brown J H
Arch Gen Psychiatry. 1979 Sep;36(10):1119-24. doi: 10.1001/archpsyc.1979.01780100089008.
The steady reduction in suicide deaths in Britain from 1963 to 1971 might superficially be credited to systematic programs to reduce suicidal behavior; but the actual saving of lives does not reflect the real upward trend in total suicidal behavior. The number of would-be suicides was in fact increasing steadily, while the proportion of fatal outcomes was being reduced, probably because the methods most commonly used for suicide had become less lethal and methods of resuscitation had improved. Attempts to reduce the amount of suicidal behavior by psychiatric treatment and by suicide prevention programs (primary prevention) seem therefore to have had little measurable impact so far. Although reduction in deaths (secondary prevention) is a more limited goal, the evidence presented justifies more systematic and deliberate efforts to reduce the lethality of the methods available.
1963年至1971年间，英国自杀死亡人数稳步下降，表面上这可能归功于减少自杀行为的系统性项目；但实际挽救的生命数量并未反映出自杀行为总数的真实上升趋势。事实上，自杀未遂的人数在稳步增加，而致命结果的比例却在下降，这可能是因为最常用的自杀方法致死性降低，以及复苏方法有所改进。因此，通过心理治疗和自杀预防项目（一级预防）来减少自杀行为的尝试，到目前为止似乎几乎没有产生可衡量的影响。虽然减少死亡人数（二级预防）是一个更有限的目标，但所提供的证据表明，有理由做出更系统、更审慎的努力，以降低现有自杀方法的致死性。
