A ‘systems’ approach to suicide prevention: radical change or doing the same things better?

Suicide is a significant public health concern. Continued high suicide rates, coupled with emerging international evidence, have led to the development of a ‘systems’ approach to suicide prevention, which is now being trialled as part of a proposed Suicide Prevention Framework for NSW (New South Wales, Australia). The Framework replicates successful international approaches. It is organised around nine components, ranging from individual to population-level approaches, to improve coordination and integration of existing services. If implemented fully, the Framework may lead to a significant reduction in suicide. However, to ensure its long-term success, we must attend to underlying structures within the system and their interrelationships. Such an approach will also ensure that policy makers and local suicide prevention action groups, particularly in rural areas, are able to respond to local challenges and incorporate multiple perspectives into their practice, including evidence for the broader social determinants of suicide.Key points • Development of the Suicide Prevention Framework for NSW draws on international evidence for a multicomponent ‘systems’ approach • The proposed Framework will ensure that interventions are integrated and will maximise available resources • To improve long-term success, the complexity of suicide and the systems that surround it need to be considered • A response that includes discussion and action on the social and political determinants of suicide is crucia