A comparative analysis of the effectiveness of suicide prevention in the USA and the Russian Federation

Over 28 years (from 1995 to 2023), the number of suicides per 100,000 people worldwide (suicide index – SI) decreased by approximately 47 % – from 15 to 8. Over the past twenty-eight years, the suicide rate in the United States has been steadily increasing, with a 20 % increase in the suicide index since 1995. In the Russian Federation, SI decreased by 5.4 times during the same period. The purpose of this study was to compare the effectiveness of suicide prevention in the United States and Russia. A comparative study of the principles and methods of suicide prevention in the United States and Russia was conducted, identifying key challenges. The study materials were statistical data published on the websites of the US Centers for Disease Control and Prevention (CDC); Letter of the Ministry of Health of the Russian Federation of March 6, 2020 No. 15-2 / I / 2-2645 “On the methodological recommendations “Suicidal behavior of minors (preventive aspects)”; Order of the Government of the Russian Federation of April 26, 2021 No. 1058 “On approval of a set of measures until 2025 to improve measures for the prevention of suicide among minors”. It was established that preventive activities to reduce suicide attempts in the United States are not effective enough, with the SI not showing a downward trend due to the following systemic problems: 1) a smaller scale of preventive impact on suicides with this activity being coordinated not at the presidential or ministerial levels, but at the level of departments (Substance Abuse and Mental Health Services Administration – SAMHSA, Centers for Disease Control and Prevention – CDC, Foundation for Suicide Prevention – American Foundation for Suicide Prevention, AFSP); 2) not all segments of the US population can afford a consultation with a qualified psychotherapist, psychiatrist, and the problem of accessing psychological care remains; 3) there is a problem of easy access to firearms. The Russian Federation has created an effective suicide prevention system. This system is distinguished by a greater scale of preventive impact than in the United States, starting from the Decrees of the President, orders of the Government of the Russian Federation, and four ministries (health, education, internal affairs, labor and social development). Problems in suicide prevention in the Russian Federation: 1) more attention is paid to issues of suicide prevention among minors, less attention is given to other age groups; 2) there are regions with high suicide rates, located mainly in the North, with a low level of social and economic development, which provokes the emergence of suicidal thoughts; 3) a shortage of qualified personnel (clinical psychologists, psychiatrists, psychotherapists) in remote regions; 4) stigmatization of mental disorders: many Russians are afraid or ashamed to consult a psychiatrist or psychologist. In order to achieve a sustainable reduction in the level of social development among residents of the Russian Federation and the United States, it is necessary to implement a comprehensive state policy aimed at realizing the economic potential of each region (state) and promoting the spiritual development of each individual. To do this, we need to learn from the positive experience of suicide prevention in the United States and Russia. Russian healthcare should adopt the US method of suicide prevention, which involves screening in primary healthcare. Russia should also promote the de-stigmatization of mental disorders.

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