title: Integration of suicide prevention program into primary health care network: a field clinical trial in Iran.
abstract: BACKGROUND
  Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds.
  
  
  METHODS
  This work as a field trial study was conducted in Nahavand and Savojbolagh from April 2010 to March 2011 (12 months). A screening tool was designed. Required capacities such as treatment, referral and registration system were provided six months before the main study. The intervention phase (for one year) including the treatment process and five consultation sessions was conducted to identify depressed people and individuals with high risk of suicide. The data were analyzed by Chi square test.
  
  
  RESULTS
  After one year of intervention, the rate of committing suicide became 4.98 and 3.36 per one hundred thousand population in Nahavand and Savojbolagh, respectively (16 and 1.6 per 100,000 in the year of before intervention respectively, 2009-2010). The female: male ratio of committing suicide was 2:1 in Nahavand and 1:1 in Savojbolagh. The most common method of committing suicide was drug intoxication in both cities. The identified cases by health workers at rural setting were 33 to 44 per 1000, in which 1.3 cases per 1000 population had been approved by general physicians.
  
  
  CONCLUSIONS
  This study approved the feasibility and efficacy of integration of suicide prevention program into PHC. The increased rate of suicide in Savojbolagh could be related to low rate of screening and lack of treatment facilities (hospitalization and electroconvulsive therapy (ECT), and part-time psychiatrist. Increasing the PHC capacities could improve the health network efficiency to identify and manage depressed and at risk of suicide individuals. Screening tool/s and method have to be improved to provide better results.
authors.affiliation: MD, Associate Professor of Psychiatry, Mental Health Research Centre, School of Behavioral Science and Mental Health, Iran University of Medical Sciences, Tehran, Iran. malakouti.k@iums.ac.ir.
authors.forename: Seyed Kazem
authors.initials: SK
authors.lastname: Malakouti
authors.affiliation: MD, Professor of Community Medicine, Department of Community Medicine, Mental Health Research Centre, Iran University of Medical Sciences, Tehran, Iran. nojomi.m@iums.ac.ir.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Nojomi
authors.affiliation: MD, Associate Professor of Psychiatry, Mental Health Research Centre, Tehran Psychiatric Institute, School of Behavioral Science and Mental Health, Iran University of Medical Sciences, Tehran, Iran. dr_ahmadkhaniha@yahoo.com.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Ahmadkhaniha
authors.affiliation: MD, Assistant Prof. of Psychiatry, Mental Health Research Centre, Hamedan University of Medical Sciences, Hamedan, Iran. hosseiny_omid@yahoo.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Hosseini
authors.affiliation: BS, Psychologist, researcher, Mental Health Office, Alborz University of Medical Sciences, Alborz, Iran. myekehfallah@yahoo.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Yekeh Fallah
authors.affiliation: MS, Clinical psychologist, Mental Health Research Centre, School of Behavioral Science and Mental Health, Iran University of Medical Sciences, Tehran, Iran. moslehmirzaie@yahoo.com.
authors.forename: Mosleh
authors.initials: M
authors.lastname: Mirzaei Khoshalani
keywords: Field trial; Primary Health Care (PHC); Suicide; Suicide prevention