title: The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population.
abstract: OBJECTIVE
  The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas.
  
  
  RESULTS
  The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas.
  
  
  CONCLUSIONS
  Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan.
authors.affiliation: Calo Psychiatric Center, Pingtung County, Taiwan; Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: forwey@seed.net.tw.
authors.forename: F-W
authors.initials: FW
authors.lastname: Lung
authors.affiliation: Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; National Suicide Prevention Center, Taiwanese Society of Suicidology in contract with Ministry of Health and Welfare, Executive Yuan, Taiwan. Electronic address: scliao@ntu.edu.tw.
authors.forename: S-C
authors.initials: SC
authors.lastname: Liao
authors.affiliation: Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; Department of Nursing, National Taiwan University, Tainan, Taiwan. Electronic address: jennycyw@ntu.edu.tw.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Taiwanese Society of Suicidology (TSOS), Taipei, Taiwan; National Suicide Prevention Center, Taiwanese Society of Suicidology in contract with Ministry of Health and Welfare, Executive Yuan, Taiwan; Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan; Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: mingbeen@ntu.edu.tw.
authors.forename: M-B
authors.initials: MB
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Gender; Intervention; Rural; Suicide rate; Urban