Suicide prevention, national policy, and local administration: challenges in policy evaluation due to governmental framework and system

Abstract

Suicide is a global public health concern. Close to 80 000 people die by suicide every year. Suicide cuts across every sociodemographic level and all regions of the world. Suicide is a consequence of social exclusion in which a person has been left without assistance. Hence social inclusion is critical in development and implementation of suicide prevention strategies. Suicides in Japan currently hold more than a quarter of global cases. National suicide rates began to rise following the economic crisis in 1998. The Basic Act for Suicide Prevention was implemented in 2006. The goal was to reduce the annual suicide rate from 24.2 in 2005 to 19.4 by 2016. In fact, the annual suicide rate in 2016 was 17.3 and lower than the target. However, the decline in mortality rates may be due to the onset of the Tohoku earthquake and tsunami of 2011. Reduction of harmful alcohol use, trauma-­informed care practices, and representation of minorities remains to be integrated into suicide prevention strategies in Japan. The co-production of the suicide prevention strategies should be sought to incorporate views from people with lived experiences into effective actions for social inclusion.