Quality improvement for suicide prevention and self-harm intervention: addressing the implementation gap and saving...

The prevention of suicide is an international priority. Self-harm is one of the most important antecedents to suicide and an important health and societal issue in its own right. Health care services have an important role to play in providing care and intervention after self-harm. As researchers, we often call for more research but there is already a substantial evidence base for the prevention of suicide and self-harm that has built up over the years. Perhaps the most pressing concern currently is the failure to implement what we know. In this Personal View, we summarise three recent national quality improvement programmes in England-one focused on suicide prevention, and two on self-harm. Aggregate observational data suggest that the initiatives might have been associated with positive outcomes in terms of reductions in the incidence of suicide and self-harm; but possibly more striking was the activity and innovation that the programmes generated. We argue that quality improvement approaches focused on suicide prevention and self-harm intervention have the potential to address the implementation gap in service provision and save lives.