Abstract
Aims: This paper has several objectives: First, it reviews the concept of suicide; Second, it presents epidemiologic data about suicide and suicidal behavior in the world, in Brazil and in Fortaleza – capital of Ceará - the second ranking city in suicide deaths in Brazil losing only to Sao Paulo which is 5 times bigger; Third, it describes the most common risk factors for suicide; Fourth, it shows interventions to reduce the risk of suicide; Fifth, it proposes useful questions to identify a person with suicide risk; Finally, it presents the PRAVIDA Program.
Methods: More specialized programs dedicated to caring for people at serious suicide risk are necessary. The manuscript describes the Life Support Program (PRAVIDA) implemented in a university hospital of Fortaleza – Ceará – Brazil.
Results: This Program was especially designed to deal with this most urgent problem in public health which suicide. PRAVIDA has broad range of activities in suicide prevention strategies are divided into three levels:
1) Primary Prevention: targets the general population a wide range of interventions such as a skills development program, educational approaches campaigns to reduce stigma during the whole year.
2) Secondary Prevention: programs such as the training of gatekeepers that seek to train individuals who can acquire knowledge and develop skills and attitudes to identify those who are at risk, determine risk levels and make referrals when necessary; school interventions involving administration, teachers, administrative and infrastructure staff, students (Pravida at Schools), screening in the emergency medical room in Instituto JoséFrota.
3) Tertiary prevention: interventions aimed at individuals who attempted suicide and include psychotherapeutic and pharmacological interventions, addressing the individual and his support network. In 17 years of continuous activities PRAVIDA did not registered a single suicide among outpatients with high suicidal risk. That it was followed up for three months after a suicide attempt.
Conclusions: Specialized team to evaluate and treat patients with severe suicidal risk is a useful strategy to prevent deaths by suicide.
Keywords
Suicide prevention, Suicidal behavior, Suicide risk factors, Epidemiology, Brazil, PRAVIDA