Suicide prevention in high risk groups

Research Question: Which interventions, aimed at people at high risk of suicide, are effective* in reducing the rate of suicide and suicide attempts?

* ‘Effectiveness’ in this context relates not only to the size of the effect, but it also takes into account any harmful or negative side effects, including inequitable outcomes.
Suicide is the leading cause of death among people in the UK aged 20-34 years. The highest suicide rate in the UK is for men aged 40–44 years.
The Public Health Research programme wishes to commission research to identify which interventions, aimed at people at high risk of suicide, are effective* in reducing the rate of suicide attempts and suicide. Interventions could come from the statutory or voluntary sectors. Examples may include:
– Interventions to prevent suicide in high risk groups, which may be defined by gender, age, ethnicity, occupation and/or other factor(s)
– Interventions to prevent suicide in those in contact with the criminal justice system (a single setting or a range of custodial settings may be considered)
– Interventions to prevent suicide in those in contact or who have been in contact with mental health services, including in secondary, primary and community care settings
– Interventions to prevent suicide by restricting access to the means of suicide
– Interventions to increase levels of support to those in different forms of crisis
Outcomes of interest may include suicide, attempted suicide, or suicidal ideation. Growing the evidence in specific sectors such as the transport (road network) or other social factors such as gambling addiction. Researchers are encouraged to consider other outcome measures, which should be specified and justified.
Commissioning brief: Studies should generate evidence to inform the implementation of single or multi-component interventions. Studies may include evidence syntheses, studies evaluating interventions, including trials, quasi- and natural experimental evaluations, and feasibility and pilot studies for these. We welcome applications for linked studies (e.g. pilot + main evaluation). Secondary analyses of existing epidemiological data and/or impact modelling studies may also be funded. We encourage the adoption of a systems perspective where appropriate to the study context. In all cases a strong justification for the chosen design and methods must be made.

The primary outcome measure of the research, if not necessarily the intervention itself, must be health-related. The positive or negative impacts of the intervention, including inequitable outcomes should be considered.  Researchers are asked to indicate how long-term impacts will be assessed. All applications should identify underlying theory and include a logic model (or equivalent) to help explain underlying context, theory and mechanisms. Proposals should ensure adequate public involvement in the research.
The impacts of public health interventions are often complex and wide-reaching. Studies should acknowledge this by adopting a broad perspective, taking account of costs and benefits to all relevant sectors of society. An appropriate health economic analysis to inform cost effectiveness, affordability or return on investment should be included where appropriate.
For all proposals, applicants should clearly state the public health utility of the outcomes and the mechanisms by which they will inform future public health policy and practice. Details about the potential pathway to impact and scalability of interventions, if shown to have an effect, should be provided, including an indication of which organisation(s) might fund the relevant intervention(s) if widely implemented.