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      Suicide Prevention in the European Region

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      1 , , 2 , 3 , 4
      Crisis
      Hogrefe Publishing
      suicide, Europe, prevention

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          Abstract

          Abstract. Although the majority of the world's suicides occur in Asia, suicide and self-harm are major concerns in Europe as well. Suicide accounts for 1.4% of the total number of deaths in Europe, with rates highest among those aged over 70 and also high among those aged 45–59 years. Europe accounts for six of the top ten countries with the highest suicide rates internationally. Although rates of suicide attempts and self-harm are not consistently recorded, evidence from hospital-based studies and school-based surveys highlight their extent and scale. Numerous countries in Europe have developed national suicide prevention strategies and action plans. Some of the suicide prevention activities in Belgium, Estonia, Finland, Scotland, France, Germany, Romania, Russia, Sweden, Ukraine, and Italy are summarized. In the chapter we also highlight novel suicide prevention projects funded by the EU which have advanced our understanding of suicide risk and have developed the evidence base for what works to prevent suicide. Examples include the European Alliance Against Depression (EAAD), Saving and Empowering Young Lives in Europe (SEYLE), Suicide Prevention Through Internet and Media Based Mental Health Promotion (SUPREME), and Reduction of Suicides and Trespasses on Railway Property (RESTRAIL). Future challenges and opportunities for suicide prevention in Europe are also discussed.

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          Most cited references12

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          Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

          Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined. Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were 'to get relief from a terrible state of mind' followed by 'to die', although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime. Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.
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            Hospital Presenting Self-Harm and Risk of Fatal and Non-Fatal Repetition: Systematic Review and Meta-Analysis

            Background Non-fatal self-harm is one of the most frequent reasons for emergency hospital admission and the strongest risk factor for subsequent suicide. Repeat self-harm and suicide are key clinical outcomes of the hospital management of self-harm. We have undertaken a comprehensive review of the international literature on the incidence of fatal and non-fatal repeat self-harm and investigated factors influencing variation in these estimates as well as changes in the incidence of repeat self-harm and suicide over the last 30 years. Methods and Findings Medline, EMBASE, PsycINFO, Google Scholar, article reference lists and personal paper collections of the authors were searched for studies describing rates of fatal and non-fatal self-harm amongst people who presented to health care services for deliberate self-harm. Heterogeneity in pooled estimates of repeat self-harm incidence was investigated using stratified meta-analysis and meta-regression. The search identified 177 relevant papers. The risk of suicide in the 12 months after an index attempt was 1.6% (CI 1.2–2.4) and 3.9% (CI 3.2–4.8) after 5 years. The estimated 1 year rate of non-fatal repeat self-harm was 16.3% (CI 15.1–17.7). This proportion was considerably lower in Asian countries (10.0%, CI 7.3–13.6%) and varies between studies identifying repeat episodes using hospital admission data (13.7%, CI 12.3–15.3) and studies using patient report (21.9%, CI 14.3–32.2). There was no evidence that the incidence of repeat self-harm was lower in more recent (post 2000) studies compared to those from the 1980s and 1990s. Conclusions One in 25 patients presenting to hospital for self-harm will kill themselves in the next 5 years. The incidence of repeat self-harm and suicide in this population has not changed in over 10 years. Different methods of identifying repeat episodes of self-harm produce varying estimates of incidence and this heterogeneity should be considered when evaluating interventions aimed at reducing non-fatal repeat self-harm.
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              Parasiticide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989

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                Author and article information

                Contributors
                Journal
                cri
                Crisis
                Hogrefe Publishing
                0227-5910
                2151-2396
                March 25, 2020
                : 41
                : Supplement: Suicide and Suicide Prevention From a Global Perspective
                : S8-S20
                Affiliations
                [ 1 ]Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sapienza University of Rome, Italy
                [ 2 ]Suicidal Behaviour Research Laboratory (SBRL), University of Glasgow, Scotland, UK
                [ 3 ]International Association for Suicide Prevention (IASP), Washington, DC, USA
                [ 4 ]Department of Psychiatry and Medical Psychology, Ghent University, Belgium
                Author notes
                Maurizio Pompili, Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy, maurizio.pompili@ 123456uniroma1.it
                Article
                cri_41_S1_S8
                10.1027/0227-5910/a000665
                32208758
                8a441dff-adec-4b84-9278-8b47260882b5
                Copyright @ 2020
                History

                Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                Europe,suicide,prevention

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