Abstract
Background: Restricting access to common means of suicide, such as firearms, toxic gas, pesticides and other, has been shown to be effective in reducing rates of death in suicide. In the present review we aimed to summarize the empirical and clinical literature on controlling the access to means of suicide. Methods: This review made use of both MEDLINE, ISI Web of Science and the Cochrane library databases, identifying all English articles with the keywords “suicide means”, “suicide method”, “suicide prediction” or “suicide prevention” and other relevant keywords. Results: A number of factors may influence an individual’s decision regarding method in a suicide act, but there is substantial support that easy access influences the choice of method. In many countries, restrictions of access to common means of suicide has lead to lower overall suicide rates, particularly regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging, by introducing “safe rooms” in prisons and hospitals. Moreover, decline in prescription of barbiturates and tricyclic antidepressants (TCAs), as well as limitation of drugs pack size for paracetamol and salicylate has reduced suicides by overdose, while increased prescription of SSRIs seems to have lowered suicidal rates. Conclusions: Restriction to means of suicide may be particularly effective in contexts where the method is popular, highly lethal, widely available, and/or not easily substituted by other similar methods. However, since there is some risk of means substitution, restriction of access should be implemented in conjunction with other suicide prevention strategies.
Highlights
Suicide is a major public health problem, representing the 10th leading cause of death worldwide [1]
Strategies aimed to limit the access to means used in suicide is effective and should be an important part of a suicide prevention strategy [10]
Violent and high-lethal methods are more frequent in males while poisoning is more common in females, and quickly accessible means are common in impulsive suicide attempters
Summary
Suicide is a major public health problem, representing the 10th leading cause of death worldwide [1]. Restricting access to means of suicide has been shown to be effective in reducing completion [3], together with strategies aimed to identify and prevent suicidal acts in individuals at risk. Restricting access to common means of suicide, such as firearms, toxic gas, pesticides and other, has been shown to be effective in reducing rates of death in suicide. In the present review we aimed to summarize the empirical and clinical literature on controlling the access to means of suicide. Restrictions of access to common means of suicide has lead to lower overall suicide rates, regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging, by introducing “safe rooms” in prisons and hospitals. Conclusions: Restriction to means of suicide may be effective in contexts where the method is popular, highly lethal, widely available, and/or not substituted by other similar
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