Lfrance has finally just adopted a genuine national suicide prevention strategy, and we can only congratulate ourselves on this! Only about forty countries in the world have one. Remember that the suicide rate in France, although decreasing for thirty years, remains higher than the average for European countries. Nearly 9,000 people die of suicide every year in our country, leaving more than 100,000 people bereaved, and more than 150,000 people attempt suicide. The economic cost of suicidal behavior in France was estimated at 10 billion euros in 2009.
The National Suicide Prevention Program – led and financed by the general directorate of health and implemented by the regional health agencies – includes a series of important measures, including the training of health professionals (to improve the management of suicidal crises) and “sentinels” (to better identify these crises, in the workplace for example), a national number, 31 14 (to know at any time where to get help), a telephone reminder system after a suicide attempt (to avoid recurrences term), an ethical communication program on suicide cases (to avoid a contagion effect), and other measures to come.
In general, it is expected that this strategy will encourage the freeing of speech by people in pain and the request for help, improve the assessment and management of suicidal crises, and stimulate networking at the local level. Like any prevention program, it will be a matter of ensuring that this tremendous initial momentum is maintained. On this point, three weaknesses seem to me to have to be highlighted and corrected to ensure the sustainability of the system.
A flaw in methodology
First of all, the program has so far not benefited from an indispensable external perspective. This audit could easily be carried out by international experts in public health and suicidology who would be happy to come and take stock (and on the cheap). It is not only a question of judging the strategy itself but also the role of associations, learned societies, representatives of patients and families.
In addition to its multimodal nature, suicide prevention has long relied on many stakeholders from various backgrounds – professionals and volunteers – who must find their place in the new system.
Then, the second weak point concerns the monitoring indicators, and in particular the most sensitive, that of deaths by suicide. The main concern is the terrible current delay of four years in obtaining this data, which is problematic in terms of guidance and evaluation. These data are available within a year in the United Kingdom and the United States, within a month in Japan (thanks to collaboration with the police).
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