title: Best practice elements of multilevel suicide prevention strategies: a review of systematic reviews.
abstract: BACKGROUND
  Evidence-based best practices for incorporation into an optimal multilevel intervention for suicide prevention should be identifiable in the literature.
  
  
  OBJECTIVE
  To identify effective interventions for the prevention of suicidal behavior.
  
  
  METHODS
  Review of systematic reviews found in the Pubmed, Cochrane, and DARE databases. Steps include risk-of-bias assessment, data extraction, summarization of best practices, and identification of synergistic potentials of such practices in multilevel approaches.
  
  
  RESULTS
  Six relevant systematic reviews were found. Best practices identified as effective were as follows: training general practitioners (GPs) to recognize and treat depression and suicidality, improving accessibility of care for at-risk people, and restricting access to means of suicide. Although no outcomes were reported for multilevel interventions or for synergistic effects of multiple interventions applied together, indirect support was found for possible synergies in particular combinations of interventions within multilevel strategies.
  
  
  CONCLUSIONS
  A number of evidence-based best practices for the prevention of suicide and suicide attempts were identified. Research is needed on the nature and extent of potential synergistic effects of various preventive activities within multilevel interventions.
authors.affiliation: Department of Developmental and Clinical Psychology, University of Tilburg, The Netherlands. C.M.vdrFeltz@uvt.nl
authors.forename: Christina M
authors.initials: CM
authors.lastname: van der Feltz-Cornelis
authors.forename: Marco
authors.initials: M
authors.lastname: Sarchiapone
authors.forename: Vita
authors.initials: V
authors.lastname: Postuvan
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Volker
authors.forename: Saska
authors.initials: S
authors.lastname: Roskar
authors.forename: Alenka Tančič
authors.initials: AT
authors.lastname: Grum
authors.forename: Vladimir
authors.initials: V
authors.lastname: Carli
authors.forename: David
authors.initials: D
authors.lastname: McDaid
authors.forename: Rory
authors.initials: R
authors.lastname: O'Connor
authors.forename: Margaret
authors.initials: M
authors.lastname: Maxwell
authors.forename: Angela
authors.initials: A
authors.lastname: Ibelshäuser
authors.forename: Chantal
authors.initials: C
authors.lastname: Van Audenhove
authors.forename: Gert
authors.initials: G
authors.lastname: Scheerder
authors.forename: Merike
authors.initials: M
authors.lastname: Sisask
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gusmão
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
mesh_terms: D000293:Adolescent; D000368:Aged; D019985:Benchmarking / Q000592:standards; D002648:Child; D003863:Depression / Q000523:psychology / Q000628:therapy; D006801:Humans; D011320:Primary Health Care / Q000592:standards; D012307:Risk Factors; D013406:Suicide, Attempted; D000078202:Systematic Reviews as Topic; D000092864:Suicide Prevention