Abstract
The Public Health Office of Lamphun Province has developed a prevention and surveillance system for suicide, called the “the community-based surveillance and preventative system for suicide” or the “Four-Pillar Strategy.” This initiative aims to reduce the suicide rate in the province, implemented across all districts since March 2024. The Four-Pillar Strategy includes 1) Data System, 2) Detection of Suicide Risk Signals, 3) Provision of Assistance and Prevention, and 4) Integrative Comprehensive Management The research conducted involved data collection through a mixed-methods approach in three sample districts to assess the implementation outcomes of the Four-Pillar Strategy. The research employed the RE-AIM, CFIR, and NPT frameworks, collecting data from February to May 2026 using research tools developed based on these frameworks. The analysis included interviews and group discussions, utilizing core content analysis following the RE-AIM, CFIR, and NPT frameworks. Community surveys were also conducted, and statistical analysis, including percentages, means, standard deviations, and F-test, was performed with a significance level set at 0.05. The study found a successful reduction of the suicide rate by 13%, with a 44% of them expressed signals of suicide ideation but did not receive assistance. This may be associated with community knowledge and attitudes towards suicide. Factors supporting the strategy's effectiveness included the characteristics of the Four-Pillar Strategy, the commitment of provincial and district authorities, internal and external communication, the competency of public health personnel and mental health networks. However, challenges in achieving the strategy's goals were linked to community awareness, attitudes, regulations, and the roles of relevant organizations, social assets, and resources. The study recommended enhancing the strategy's effectiveness by developing a sub-district-level epidemiological data system, risk-based prevention and intervention systems, fostering community awareness and reduce stereotypes of suicides, developing problem-solving skills and self-esteem, improving communication within and between health organizations, strengthening counseling centers, and enhancing the capabilities of stakeholders in the Four-Pillar Strategy. This research provides valuable insights for Lamphun Province to further develop its suicide prevention efforts and serves as a reference for other provinces in planning community-based suicide prevention initiatives.
