Multidimensional approaches to suicide prevention: innovations, challenges, and future directions

Suicidalbehaviorresults fromacomplexinteraction of various factors (biological, clinical, psychological, and socio-cultural), as outlined by the following multidimensional three-level model: (a) distal-predisposing factors: genetic and neurobiological vulnerability, early life adversity, and personality traits; (b) mediating factors: chronic mental disorders, substance use, and persistent interpersonal difficulties; and (c) proximal-precipitating factors: relationship breakdown, job loss, access to lethal means, exposure to suicide in others, and acute mental health symptoms.