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To the Editor: Dr Mann and colleagues¹ provide a comprehensive review of specific strategies that may be effective for reducing the public health burden and personal loss due to suicide. However, their categorization of the Air Force Suicide Prevention Program (AFSPP) as a "gatekeeper" strategy for preventing suicide (in Table 1 of their article) is an oversimplification of a multifaceted suicide prevention program that has demonstrated sustainability in reducing suicide events.^2-5

The AFSPP comprises 11 initiatives that use a comprehensive approach that integrates different strategies, one of which is the gatekeeper programs. These additional strategies include public educational campaigns, curriculum-based programs, community preventive and clinical services, and policy changes. The AFSPP is distinctive because of its adoption of the integrated framework to prevent suicide. Mann et al recognize that there are few data indicating which components of multifaceted programs are responsible for delivering the desired effects. Answering this question requires . . . [Full Text of this Article]

Kerry L. Knox, PhD
kerry_knox@urmc.rochester.edu
Department of Community and Preventive Medicine

Eric D. Caine, MD
Department of Psychiatry
University of Rochester School of Medicine
Rochester, NY

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