Impact of a High-resolution Program for the Prevention of Suicidal Behavior in At-risk Adults: a Quasi-experimental Ambispective Cohort Study

INTRODUCTION.

Epidemiological and Clinical Impact of Suicidal Behavior. Suicidal behavior is a phenomenon of increasing impact and one of the main public health concerns globally. According to the most recent data from the World Health Organization (WHO), published in 2025, more than 720,000 people die by suicide each year worldwide, a figure far exceeded by the number of attempts. It is estimated that for every completed suicide, there are approximately 20 attempts, and this is why these prior suicidal behaviors are consolidated as the individual risk factor with the greatest predictive value for future episodes. Suicidal behaviors generate extreme suffering with profound repercussions for both the individual and their socio-familial environment, thus generating a health and social impact of great magnitude. This is why suicide prevention has currently become a strategic priority on public health agendas.

In Spain, according to the latest data from the National Institute of Statistics (INE), there were 4,116 deaths by suicide in 2023, making it the second leading cause of death from external causes. The crude rate is 8.5 suicides per 100,000 inhabitants, with a notably asymmetrical distribution between sexes: 74% of cases correspond to men and 26% to women. These figures translate to an average of ten people committing suicide in Spain every day, highlighting the urgent need for effective clinical and preventative interventions.

Regulatory and strategic framework. The prevention of suicidal behavior is based on a solidly defined international and national strategic framework. Globally, the WHO's Action Plan for Suicide Prevention 2013-2030 establishes, in its third objective, the imperative need to implement mental health promotion and prevention strategies throughout the life cycle, with a commitment to reducing the suicide rate by one-third by 2030. In the Spanish context, the National Health System's (SNS) Mental Health Strategy 2022-2026 prioritizes, in its third strategic line, strengthening prevention, early detection, and optimizing the quality of care in this area. These guidelines are reinforced by the SNS's specific Action Plan for Suicide Prevention 2025-2027, which intensifies these measures with special emphasis on the most vulnerable groups and promotes intersectoral coordination as a response from the healthcare system.

Under this paradigm, the need arises to design effective and humanized intervention strategies as a comprehensive response, offering an effective response to the problem of suicide from a preventive, specialized, and community-based approach. Suicidal behavior is a preventable phenomenon through systematic and multidisciplinary actions.