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There is insufficient or conflicting evidence concerning the effectiveness of the remaining approaches. We conclude that the evidence base for effective suicide prevention is far from convincing. Major improvement in the extent and quality of collaboration between researchers, policymakers, and practitioners and a considerable increase in funding for evaluation studies in suicide prevention are required if the current knowledge gap about effective interventions is to be bridged.This final chapter focuses on the progress made so far in the area of suicide prevention and calls attention to considerations for future work. Recommendations for the implementation of national suicide prevention strategies are proposed, including close collaboration between countries within the same geographic region, as well as guidance from countries wherein national strategies have successfully implemented, such as the sharing of effective strategy templates. In addition, the value of accurate surveillance data in overcoming barriers, informing actions and responding to real time trends in suicide and self-harm is emphasized. The need for more systematic research into the efficacy of intervention and prevention approaches is also highlighted. Furthermore, the provision of governmental support to ensure long-term sustainability of national suicide prevention strategies is endorsed. Approaches to enhance the evaluation of the efficacy of national suicide prevention strategies and interdisciplinary partnerships and collaborations are discussed. Finally, recommended resources to assist in implementing and evaluating key components of national suicide prevention strategies are listed.In this introductory chapter, we provide the background and rationale for the compilation of overviews of national suicide prevention strategies from all geographic regions globally. Currently, suicide is the second leading cause of death among young people aged 15-29 years at global level. Overall, suicide rates in low- and middle-income countries (LMIC) are lower than the rates in high-income countries (HIC) of 11.2 per 100,000 compared with 12.7 per 100,000 population, but the majority of suicide deaths worldwide occur in LMICs. However, there are ongoing challenges in relation to the accuracy of suicide figures in many countries. The rationale for the global approach to suicide prevention is linked to major strategic documents provided by the WHO, including the Global Mental Health Action Plan, 2013-2020, the WHO report Preventing Suicide A Global Imperative, in 2014, and the United Nations Sustainable Development Goals (SDGs) for 2030, including a target of reducing premature mortality from noncommunicable diseases by one-third, with suicide mortality rate identified as an indicator for this target. see more In addition, a review is provided of the evidence base and best practice of suicide prevention programs.Although the majority of the world's suicides occur in Asia, suicide and self-harm are major concerns in Europe as well. Suicide accounts for 1.4% of the total number of deaths in Europe, with rates highest among those aged over 70 and also high among those aged 45-59 years. Europe accounts for six of the top ten countries with the highest suicide rates internationally. Although rates of suicide attempts and self-harm are not consistently recorded, evidence from hospital-based studies and school-based surveys highlight their extent and scale. Numerous countries in Europe have developed national suicide prevention strategies and action plans. Some of the suicide prevention activities in Belgium, Estonia, Finland, Scotland, France, Germany, Romania, Russia, Sweden, Ukraine, and Italy are summarized. In the chapter we also highlight novel suicide prevention projects funded by the EU which have advanced our understanding of suicide risk and have developed the evidence base for what works to prevent suicide. Examples include the European Alliance Against Depression (EAAD), Saving and Empowering Young Lives in Europe (SEYLE), Suicide Prevention Through Internet and Media Based Mental Health Promotion (SUPREME), and Reduction of Suicides and Trespasses on Railway Property (RESTRAIL). Future challenges and opportunities for suicide prevention in Europe are also discussed.This chapter provides an update on suicide and suicide prevention in the Southeast Asia Region, which covers 11 low- and middle-income countries, accounting for 26% of the world's population. More than one third (39%) of all suicides globally, occur in this region, with the highest suicide rate of 17.7 per 100,000, which is likely to be an underestimate due to differences in study populations, research methodology, and uncomprehensive data registration systems. The risk profile of people who die by suicide and the characteristics of suicides in Southeast Asia are distinctly different from other regions in many ways. In this region the male-female ratio for suicide is closer to 1, compared with 35 in higher-income countries, and the overall reported prevalence of mental disorders, such as depression or other psychiatric conditions, is lower. Both older people and adolescents show the highest rates of suicide. Suicide involving pesticide poisoning is the most common method used in both rural and urban areas in countries in this region. Updates are provided on national and regional suicide prevention activities in Bangladesh, Bhutan, Nepal, India, Sri Lanka, and Thailand.The Americas encompass the entirety of the continents of North America and South America, representing 49 countries. Together, they make up most of Earth's western hemisphere. The population is over 1 billion (2006 figure), with over 65 % living in one of the three most populated countries (the United States, Brazil, and Mexico). The Americas have low-, middle-, and high-income countries. Data from this region have not been readily and consistently available. There are several English-speaking Caribbean nations and countries in South America that have not had updated information. This chapter will focus on suicide prevention within North America (United States and Canada), some countries in the Caribbean region, and some countries in South America. Guyana, Suriname, and Trinidad and Tobago have severe issues with pesticide suicide, with average rates of 44.2 (global rank 1); 27.8 (global rank 5) and 13.0 (global rank 41) per 100,000 respectively. Jamaica, however, had one of the lowest rates 1.2 per 100,000 (global rank 166).