Practice manual for establishing and maintaining surveillance systems for suicide attempts and self-harm.

Suicide is a complex phenomenon. It is estimated that over 800 000 people die by suicide each year, with many more attempts for each death that occurs. Importantly, suicides are preventable. Timely and effective evidence-based interventions play a key role in preventing suicides and, in order to determine what is effective, good data are needed as a priority. Governments are in a unique position to develop and strengthen surveillance and to provide and disseminate data that can help to inform action. In its report Preventing suicide: a global imperative, WHO set out a number of areas for action for governments, regardless of their level of progress in implementing suicide prevention activities. A key area was the improvement of data on suicides and suicide attempts. This manual builds on these areas of focus by providing practical steps and guidance on setting up a surveillance system for suicide attempts and self-harm within countries. Efforts have been made to improve the registration of suicides; however, a renewed emphasis on the registration of suicide attempts, and self-harm in particular, can add valuable information to guide the design of suicide prevention strategies, as previous suicide attempts are an important risk factor for future attempts and for death by suicide. The manual includes consideration of stakeholder engagement, funding and staffing, through to data collection, collation and analysis. This is a practical manual that will allow policy-makers to prioritize and guide the implementation of a surveillance system for suicide attempts and self-harm in their respective countries. Users of the manual are encouraged to adapt the steps realistically to match the resources available in their specific context and to ensure sustainability. Importantly, improving the quality of data can help to guide and prioritize the best interventions in each context and contribute to an effective overall suicide prevention strategy