title: National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities.
abstract: OBJECTIVE
  In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities.
  
  
  METHODS
  The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey.
  
  
  RESULTS
  Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs.
  
  
  CONCLUSIONS
  The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities.
authors.affiliation: Mental Health and Nursing Research Team, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
authors.forename: Miharu
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takeshima
mesh_terms: D003153:Community Health Services / Q000191:economics / Q000592:standards*; D003430:Cross-Sectional Studies; D006291:Health Policy / Q000191:economics*; D006801:Humans; D007564:Japan; D009111:Local Government; D015397:Program Evaluation / Q000706:statistics & numerical data*; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
keywords: Japan; health policy; local government; suicide