lent Death Reporting System provides a promising framework that might be expanded into a national program that would provide the database for suicide deaths. The Oregon State Adolescent Suicide Attempt Data System is one of a few mechanisms that might inform the creation of a national system for reporting suicide attempts. Issues of confidentiality are a concern for surveillance of suicide as they are for HIV/AIDS. However, CDC found that reporting through a name-based system did not impact rates of testing for HIV/AIDS. As state and pilot programs have shown, there are options available that are sensitive to confidentiality yet allow the benefits of a reporting system (see Chapter 10). The committee is strongly committed to the principle of confidentiality and would urge that implementation of surveillance programs be done in a manner that respects the privacy of the individual and their families and communities. Yet examples exist of reporting systems that deal effectively with this issue. Consequently the committee sees no fundamental reason why these approaches cannot be applied to the reporting of suicide and suicide attempts.

Recommendation 2

National monitoring of suicide and suicidality should be improved. Steps toward improvement should include the following:

  • Funding agencies (including NIMH, NIA, NICHD, NIDA, NIAAA, CDC, SAMHSA and DVA) should encourage that measures of suicidality (e.g., attempts) be included in all large and/or long-term studies of health behaviors, mental health interventions, and genetic studies of mental disorder. Funding agencies should issue program announcements for supplements to ongoing longitudinal studies to include the collection and analysis of these additional measures.

    • Suicidal patients should be included in clinical trials when appropriate safeguards are in place.

    • A national suicide attempt surveillance system should be developed and coordinated through the CDC. It might be developed as part of a broader injury reporting database. Modeled after Oregon’s program for the reporting of adolescent suicide attempts and the HIV/AIDS registry, pilot programs should be developed, tested, and implemented as soon as feasible. State participation should be encouraged by requiring reporting as a prerequisite for receiving funding for related programs.

  • Federal funding should be provided to support a surveillance system such as the National Violent Death Reporting System that includes

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