KEY POINTS:
An informal New Zealand network of research workers on suicide has criticised school-based programmes that focus on raising awareness on suicide.
"There is little evidence that didactic school-based suicide prevention programmes which focus on raising awareness about suicide in schools students... are effective in reducing suicidal behaviour and there are concerns that such programmes may not be safe," says their report, published in the New Zealand Medical Journal.
The Suicide Research Network said there had been suggestions that young people exposed to such programmes either showed no benefits or a decrease in desirable attitudes.
There were also concerns that the format and content of the programmes might inadvertently normalise suicidal behaviour or promote imitation, the researchers said.
"Until there is clear evidence that such programmes are both beneficial and without risk, their use cannot be recommended.
However, the network did say that school-based "competency-promoting" programmes which enhanced self-esteem and problem solving skills were promising.
The researchers said there was no evidence that public health messages about suicide were beneficial and there were concerns that such messages might risk "normalising suicide rather than preventing it."
One of the authors of the report was researcher Annette Beautrais, whose views on media reporting of suicide have been criticised in some newspaper reports lately, co-author Roger Mulder said.
Editorials had argued that Dr Beautrais' views have been too influential in determining policies regarding the media reporting of suicide and that restrictions on media had contributed to New Zealand's high rates of suicide.
Professor Mulder said the viewpoints in those reports were not sound and that there was no evidence that media reporting was beneficial in reducing suicidal behaviours.
A national suicide prevention strategy for New Zealand was developed last year.
The Suicide Research Network said there was little strong evidence for the efficacy of many existing suicide prevention initiatives.
It said the available evidence suggested the most promising interventions in reducing suicidal behaviour involved educating medical practitioners and "gatekeepers" -- clergy, school, prison and welfare workers -- and restricting access to lethal means of suicide.
It said providing doctors in primary care with training to enable them to better recognise and treat depression had been shown to result in improved treatment of patients with depression, and in lower suicide rates.
"This approach is based on knowledge that, often, depression is under-recognised and inadequately treated, and that, in many countries, those who die by suicide see a medical practitioner in the weeks before their death."
The researchers said evidence from several countries, including New Zealand, suggested that reducing access to particular means of suicide reduced the rate of death by that method.
These included reducing access to domestic gas, legislative restrictions on gun possession and control, reducing carbon monoxide emissions from vehicles, restricting availability of pesticides, and installing barriers at sites that become popular for suicide.
Other measures were reducing the pack size of analgesics, various restrictions on prescribing drugs which are toxic in overdose and prescribing drugs which have "relatively low lethality if taken in overdose."
The researchers said programmes that focused on enhancing the skills of community and institutional "gatekeepers", including clergy, and workers in schools, prisons and welfare centres, could improve identification and referral of people at risk of suicidal behaviour.
- NZPA
