Interventions to prevent suicide a literature review to guide evaluation of California's Mental Health Prevention and Early Intervention Initiative

Summary: There are more than 3,000 suicide deaths in California each year -- roughly nine deaths for every 100,000 California residents. To prevent suicides and other mental health problems, the California Mental Health Services Authority (CalMHSA) is implementing a variety of Prevention and Early Intervention (PEI). CalMHSA asked RAND to evaluate the PEI initiatives to prevent suicide. To help inform the design of this evaluation, we reviewed some key aspects of the suicide prevention (SP) program evaluation literature, including relevant theories of change, what is and is not known about suicide prevention program effectiveness, and what kinds of methodologies have been previously used in evaluations of suicide prevention programs. This report summarizes this scientific literature related to suicide prevention and is organized into three sections. First, we provide an overview of the epidemiology of suicide and of non-fatal self inflicted injuries in California, as well as the empirical support for suicide risk factors, and explain why understanding this epidemiology is a critical first step in any effort to evaluate the effectiveness of suicide prevention programs. Second, we present our framework for conceptualizing suicide prevention programs that can be used to guide evaluation; it is based on a review of the relevant scientific literature. Finally, we conclude with a discussion of the measures that have been used to evaluate suicide prevention programs in the past.

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