Abstract
The mental health target in the green paper Our Healthier Nation is “to reduce the death rate from suicide and undetermined injury by at least a further sixth (17%) by 2010, from a baseline at 1996.”1 The former government's Health of the Nation strategy included two suicide targets—namely, a 15% reduction in the overall suicide rate and a 33% reduction in the rate in the severely mentally ill.2 The initial suicide targets were controversial, argument centring on the advisability of a target for a relatively uncommon event (about 5000 suicides and open verdicts each year in England and Wales), the difficulty of predicting suicide, and the pressure the targets might place on psychiatric services. Nevertheless, the overall suicide rate has declined since the original targets were set. Most importantly, the previous rapid rise in suicides in men aged 15-44 years has started to reverse.1 Why do we still need a suicide target and can suicide rates be reduced further? Suicide is usually the tragic end point of various possible pathways, influenced by mental ill health and psychological, socioeconomic, familial, interpersonal, …

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