Suicide in Britain. More attempts, fewer deaths, lessons for public policy.

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.