TY  - JOUR
A1  - Köhler, Judith
A1  - Heinz, Ines
A1  - Mergl, Roland
A1  - Elsner, Anne
A1  - Hegerl, Ulrich
T1  - The German Alliance Against Depression and suicide rates: A retrospective analysis
T2  - PLOS ONE
N2  - Supported by the German Alliance Against Depression, 82 regions in Germany launched their own community-based multi-level intervention programs targeting both depression and suicidal behavior prior to January 2016. Sixteen of these regions have implemented the full 4-level intervention program comprising 1) training of General Practitioners, 2) a public awareness campaign, 3) training of community facilitators and 4) support for depressed patients and their relatives for at least three years. The aim of the study was to examine possible suicide prevention effects in these sixteen 4-level intervention regions (comprising a population of 6,976,309) by 1) comparing the annual suicide rates during the 3-year intervention period to a 10-year baseline and 2) comparing these differences to corresponding trends in Germany after excluding all intervention regions (Germany-IR). Primary outcome was the annual rate of suicides. Analyses included negative binomial regression models. When examining differences between suicide rates during the intervention period compared to the baseline period, only a trend towards a significant reduction was found. This reduction of suicides in the sixteen 4-level intervention regions did not differ from that in Germany-IR as control. The interpretation of these findings has to take into account that the training of General Practitioners, police and other community facilitators might have improved the recognition of suicides, thus increasing detection rates. Furthermore, destigmatizing effects of the public awareness campaigns might have increased the number of suicides by lowering suicide threshold (“normalization”) for those at risk and by decreasing the rate of suicides deliberately hidden by suicide victims or their relatives.
KW  - Suicide
KW  - Germany
KW  - Community based intervention
KW  - Behavior
KW  - Depression
KW  - Cities
KW  - Police
KW  - Preventive medicine
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62706
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-627067
SN  - 1932-6203
N1  - YES UH received financial funding (grant ZMVI1-2517FSB142) from the Federal Ministry of Health (www.bundesgesundheitsministerium.de) for a project which included this analysis.
VL  - 16
IS  - 7, art. e0254133
SP  - 1
EP  - 11
PB  - PLOS
CY  - San Francisco, California, US
ER  -