Coordinated suicide prevention: an interplay of many actors

Suicide prevention can only be successful if all actors work together with common goals. Their commitment has resulted in progress in a number of areas in recent years, yet there is still a great need for action. This is illustrated by an analysis of the implementation status of the National Action Plan on Suicide Prevention in Switzerland carried out by Infras in 2021 on behalf of the FOPH (see lead article).

At the federal level, the implementation of the action plan is under the leadership of the FOPH, which performs networking and coordinating tasks to support the players and provides knowledge management. But other federal offices also play a role in suicide prevention. For example, the Federal Social Insurance Office (FSIO) has been working for many years to promote media skills in adolescents and therefore plays an important role in implementing the item from the Suicide Prevention Action Plan “Increase adolescents’ awareness of the need to engage with the internet and digital communication channels responsibly and respectfully, and support them in doing so”. And in 2022 the State Secretariat for Migration (SEM) published a report on suicide prevention in the federal asylum centres in French-speaking Switzerland.

Many cantons are also involved in suicide prevention, some actively, some by implication, through their focus on mental health (which is also part of the Suicide Prevention Action Plan). The canton of Zurich, for example, actively pursues its own suicide prevention programme. “Ideally, suicide prevention happens in various settings and with different actors”, says Martina Blaser, who heads the priority programme, “because suicide and attempted suicide have multiple causes. A cross-cutting cantonal programme enables these tasks to be bundled and implemented systematically. This approach has proven effective in the canton of Zurich since 2015.” Suicide prevention in Zurich covers a wide range of activities from comprehensive public relations work and projects focusing on method-specific suicide prevention to continuing training for specialists.

In other cantons suicide prevention is organised on the basis of service level agreements. In Aargau, for example, the association Suizid-Netz Aargau carries out information and education activities and initiates service offerings (with support from the Mental Health cantonal action programme). “A coordinated and effective offering has been established over a number of years”, says Vilma Müller, Head of the Mental Health Aargau priority programme. “Two or three continuing training events are held every year for multipliers, a group that includes school social workers and the Spitex home nursing service. We recently introduced an e-learning course for specialists to enable them to identify risks and find ways of approaching at-risk individuals. Every year we organise events for the general public to tie in with World Suicide Prevention Day.”

Civil society also plays an important role. For example, Stop Suicide, an NGO operating in French-speaking Switzerland, organises prevention workshops for adolescents and training events for specialists. “We are also active in the social media and organise sports and cultural events to increase awareness”, says Léonore Dupanloup, Head of Communication and Media Prevention. “Our activities aim to break the taboo surrounding suicide, promote selfhelp and goodwill, and make the help available for mental health issues better-known.”

In Switzerland the task of achieving interplay between the numerous actors in suicide prevention – a major requirement if the action plan is to be implemented jointly – is often challenging because of the lack of resources, federal structures and inconsistent responsibilities. The analysis of the implementation status shows that the task for the future will be to expand cooperation and networking between the actors and make better use of the potential synergies between the many offerings available.