[Establishment of a comprehensive anti-suicide project in an urban city]

For the establishment of an effective comprehensive anti-suicide policy, a multifaceted strategy including primary, secondary, and tertiary prevention measures is needed. In urban cities, however, there are many obstacles to projects such as comprehensive programs for suicide prevention. In Sendai city, which has a population of approximately 1,000,000, a comprehensive anti-suicide project was launched as a public enterprise as a pioneer among ordinance-designated cities in Japan. This project was supported by several important factors. 1) A series of epidemiological observation and intervention studies on depression among the elderly had previously been conducted in a large residential district. As a result, a comprehensive community program for depression among the elderly was implemented as a public enterprise and a subsequent decreasing trend in the later-life suicide rate was found. 2) The municipal authorities recognized the importance of the anti-suicide program and made an effort to reorganize the existing health-related programs in terms of suicide prevention. 3) the action of the municipality was facilitated by the passing of an anti-suicide law by the National Diet in 2006 and the establishment of fundamental principles for a comprehensive anti-suicide policy by the National Diet in 2007. 4) The activities of nongovernmental groups also influenced the municipality. In order to establish a comprehensive anti-suicide program in urban cities with a large population, an interaction model in which various governmental and nongovernmental networks influence and activate each other should be considered.