Early identification, assessment, management and follow-up of everyone affected

Health services are often the entry point for people in distress or for those who have made a suicide attempt where early identification, assessment, management and follow-up care can be provided. In the context of non-specialist health settings, WHO has developed the Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders and accompanying mhGAP Intervention Guide (‎mhGAP-IG)‎ Version 2.0 for identification, assessment and management of mental health conditions, including a specific module on suicide and self-harm. A virtual course on self-harm/suicide has been developed by the WHO Regional Office of the Americas to train primary healthcare workers in the detection, management and prevention of suicide and self-harm. The mhGAP Evidence Resource Centre includes evidence-based recommendations for management of self-harm and suicide in non-specialized health settings and for population-based interventions.

While the target user group for mhGAP is non-specialized healthcare providers working at first- and second-level health-care facilities, health planners, managers, and policy makers working at the health systems level should also be involved. Suicide prevention should be incorporated as a core component in the health system to intervene early when people are found to be at risk of suicide.

To scale up services for people with mental health conditions and people affected by suicidal behaviours, WHO has developed the mhGAP community toolkit. The toolkit provides guidance for programme managers on how to identify local mental health needs and tailor community services to match these needs. It offers practical information and necessary tools for community providers to promote mental health, prevent mental health conditions and suicide and expand access to mental health services.

Not only health workers, but also first line responders such as police or firefighters, teachers, employers, jail and prison officers and others (often referred to as gatekeepers) who are likely to come into contact with someone at risk should be able to identify and support people who are at risk of suicide. To this end, WHO has produced a series of infographics and resources addressed to specific social and professional groups, including police, firefighters and other first line responders, so that people who are in distress receive the support they need.

For workplace settings, WHO has produced Guidelines on mental health at work, which provide evidence-based recommendations to promote mental health and prevent suicide and mental health conditions in the workplace. A resource targeting employers and colleagues to prevent suicide at work has also been produced.

People who have been bereaved by suicide have been identified as being at risk of suicide. Support should be available and can be provided by health services and community-led peer support groups. WHO guidance on how to start a suicide bereavement support group is available. 

Many persons who are suicidal may not seek help from face-to-face health services or support from friends or family members. The WHO Eastern Mediterranean Regional Office has developed a Mental Health and Psychosocial Support (MHPSS) self-help online module on suicide prevention to support anyone experiencing suicidal ideation, self-harm or bereavement by suicide manage their own emotions, as well as guidance in providing support to others who may be feeling suicidal.

The confidential services offered by crisis lines may help overcome the barrier of stigma surrounding suicide and mental health problems that could prevent a person from seeking help in other ways. WHO has produced a resource for establishing a crisis line to assist countries in the design and delivery of a confidential crisis line. Alongside a range of other interventions for the prevention of suicide, crisis lines play a complementary role.

Publications

Mental Health Gap Action Programme (mhGAP) guideline for mental, neurological and substance use disorders

The mhGAP guideline supports countries to strengthen capacity to deal with the growing burden of mental, neurological and substance use (MNS) conditions...

mhGAP Intervention Guide - Version 2.0

This is the second version (2016) of the mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use (MNS) disorders in non-specialist...

The mhGAP community toolkit: field test version

The mhGAP community toolkit: field test version is an integral part of WHO's Mental Health Gap Action Programme (mhGAP), and aims at scaling up services for...

Guidelines on mental health at work

An estimated 15% of working-age adults have a mental disorder at any point in time.  Depression and anxiety are estimated to cost the global economy...

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