Abstract
The next steps forward in suicide prevention are to learn (i) how to best combine single measures into a multilevel intervention in order to create additive and synergistic effects and (ii) how to implement them in the communities in different cultures and healthcare systems. A narrative review based on findings and experiences from existing community-based multilevel interventions which have provided some evidence for preventive effects on suicidal behaviour is presented. Most multilevel interventions combine training for primary care providers and gatekeepers, public awareness activities, restricting access to lethal means, engaging with the media, and support for high risk groups. However, effects on completed suicides and/or suicide attempts have only been reported for a few interventions. The best evaluated community-based intervention is the four-level programme offered by the European Alliance Against Depression (EAAD; implemented in over 115 regions in 15 countries by 2019).
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