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Citation |
Mishara BL, Stijelja S. JAMA Pediatr. 2020; ePub(ePub): ePub. |
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Copyright |
(Copyright © 2020, American Medical Association) |
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DOI |
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PMID |
32716485 |
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Abstract |
In Reply Lennon and Hassan react to our 3 potential explanations of increasing US youth suicide rates1 in spite of the implementation of national prevention strategies with the contention that our first explanation (current approaches to youth suicide prevention are ineffective) must be accepted because "effectiveness in the context of rising rates is simply fallacious." This affirmation confounds the clinical effectiveness of treatments and prevention initiatives with the impact of a program of actions on population incidence trends. The actions in the US suicide prevention strategies are for the most part evidence-based interventions that have proven their effectiveness in the best research we have to date, as recommended based on systematic reviews, for example, by the World Health Organization.2 An ecological fallacy in the interpretation of populational data occurs when inferences about the nature of individuals (ie, that suicides are not being prevented) are deduced from inferences about the group to which those individuals belong. Lack of aggregate decreases in suicide rates following a program of preventive interventions does not prove that some, many, or even most of the interventions have not saved lives. The other explanations must be considered as potentially valid and they merit being tested empirically. Implementation research3 can determine whether suicide prevention programs have been implemented sufficiently, their target population was appropriately identified, and if there was sufficient coverage to expect significant changes in overall suicide rates... Language: en |