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Reducing Suicide: A National Imperative
and Prevention’s efforts in violence prevention in the mid-1980s highlighted the high rates of suicide among youth and led to a task force on youth suicide. Suicide became a central issue worldwide in the mid-1990s. At this time, several private foundations and public-private partnerships became active in the United States. A seminal conference was held in Reno, Nevada in 1998 that summarized recommendations for action. In 1999, the Surgeon General of the United States issued a “Call to Action to Prevent Suicide” (PHS, 1999), and soon after presented a comprehensive assessment of future goals and objectives to combat suicide (PHS, 2001). The federal commitment to reducing suicide rate is further illustrated by the goals of Healthy People 2010 to reduce the overall suicide rate to 6 per 100,000 by the year 2010 and to reduce adolescent suicide attempts by one percent each year (US DHHS, 2000).
STATEMENT OF TASK
Despite its long history and the deep suffering it causes, despite the increased understanding that has come with research over the past decades, suicide continues to claim tens of thousands of lives each year. While the National Strategy presents 11 goals and multiple objectives, specific actions still need to be designed. In 2000, several federal agencies (the National Institute of Mental Health, the National Institute of Drug Abuse, the Veterans Administration, the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and the National Institute on Alcohol Abuse and Alcoholism) joined together to fund an Institute of Medicine study in an effort to explore new directions for the field. In the autumn of 2000, the Committee on Pathophysiology and Prevention of Adolescent and Adult Suicide was formed to examine the state of the science base, gaps in our knowledge, strategies for prevention, and research designs for the study of suicide. A committee was constituted with a broad range of expertise, including neuroscience, genetics, epidemiology, sociology, anthropology, psychology, psychiatry, and community interventions. While some members of the committee were experts in suicidology, the committee also included many who were not suicidologists but whose relevant expertise could contribute to a fresh view of the subject. The committee was asked to address the following tasks:
An assessment of the science base of suicide etiology, including cognitive, affective, behavioral, sociological, epidemiological, genetic, epigenetic, and neurobiological components. This will include an examina-