The National Suicide Observatory (ONS), established by decree in September 2013, operates under the authority of the Minister of Social Affairs and Health. The deputy chair is held by the director of the Drees, and the secretariat is managed by the Drees.

The ONS’s missions

The Observatory’s missions range from research to prevention and evaluation. They can be broken down into five areas:

• coordinating the various data producers and improving the monitoring of suicides and suicide attempts (SA),

• developing knowledge on risk factors and the mechanisms leading to suicides and suicide attempts in order to improve prevention,

• promoting and enhancing systems for collecting, monitoring, and alerting regarding suicide by participating in the dissemination of results and facilitating access to databases,

• evaluating the impact of public policies on suicide and SUI prevention,

• issue recommendations, particularly regarding prevention.

The ONS is an independent, multidisciplinary observatory whose membership reflects the diversity of stakeholders working in suicide prevention (legislators, government agencies, healthcare professionals, experts, researchers, stakeholders, health agencies, etc.).

The Role of Santé publique France in the ONS

The ONS is organized into two working groups:

• The first is led by Santé publique France and focuses on the surveillance of suicides and suicide attempts.

• The second, led by Drees, is responsible for improving understanding of the mechanisms underlying suicides and suicide attempts and for promoting research on this topic.

Working Group on 'Surveillance of Suicides and Suicide Attempts'

In previous years, the working group produced an overview of the data sources on suicide and suicide attempts available in France, provided subnational data on suicide and suicide attempts to better guide local policies, and developed recommendations for improving these sources. Building on this work, in 2017, the Working Group on "Surveillance of Suicides and Suicide Attempts" focused on two main objectives:

• To improve data and knowledge on suicide and suicide attempts, in accordance with the recommendations issued in the first ONS report, by establishing collaboration with forensic medicine services to improve data and knowledge on suicide; and, regarding the improvement of data and knowledge on suicide attempts, a collaboration was established between Santé publique France (national directorates and regional units), the Federation of Regional Emergency Observatories, experts in medical information, emergency physicians, and psychiatrists.

• Contribute to standardizing data collection by suicide prevention and helpline organizations.

2018: Publication of the ONS’s third report: Suicide—Ethical Issues in Prevention, Unique Aspects of Suicide in Adolescence

This report consists of four parts:

• Two sections titled: - Ethical Issues Associated with Suicide Prevention. - Research, Literature Review, and Research Directions on Adolescent Suicide.

• Progress of the work - Update on the work of the "Suicide Prevention" working group of the National Council for Mental Health - Progress of the work of the working groups on improving data on suicide and suicide attempts at the National Suicide Observatory - Follow-up on research on suicide prevention sponsored by the National Suicide Observatory

• Seven fact sheets present findings derived from data from specific information systems and surveys: - Epidemiological data on suicide deaths - Hospitalizations for attempted suicide in medical and surgical wards in France - Suicide attempts and suicidal thoughts among young people in France. Results of the 2014 ESCAPAD and 2015 ESPAD surveys - Monitoring of suicide mortality among active farmers. Situation in 2010–2011 and trends from 2007 to 2011 - Socioprofessional characteristics associated with suicide mortality among male active farmers between 2007 and 2011 - Measures implemented to prevent suicide among prison staff - Survey of the activities and practices of forensic institutes in France in 2016, aimed at improving knowledge of mortality data

• Appendices, including a digital compendium on the ethical issues associated with suicide prevention, on the topic of suicide and excessive debt, and on suicide.

Suicide - Understanding to Prevent: National, Local, and Community Dimensions

Suicide: Understanding to Prevent: National, Local, and Organizational Dimensions

This report consists of 4 parts:

• Two sections titled: - Data and initiatives of suicide prevention organizations in France - Risk factors for suicide and vulnerability to suicide

• Review of action plans - National Suicide Prevention Program (2011–2014) - 2011–2014 National Action Plan Against Suicide by the Mutualité sociale agricole - Suicide prevention policy for incarcerated individuals

• Local data - Presentation of data on deaths by suicide in 2012 and hospitalizations for suicide attempts in 2013 by region and by department

• Seven fact sheets present results derived from information system data: - Epidemiological data on deaths by suicide - Measurable period and generation effects in death statistics - Relationship between hospitalization in general medicine for suicide attempts and suicide - Hospitalizations for suicide attempts in general medicine and surgery in France - Suicide attempts and suicidal thoughts reported in the 2014 Health Barometer of the overseas departments - Prevalence and trends in suicidal behavior in metropolitan France in 2014 - Monitoring of suicide mortality at the level of a company or institution: the example of the prison administration

• Appendices, including a digital compendium on the topics of suicide, excessive debt, and suicide.

Suicide: State of the Art and Research Prospects - 1st Report/November 2014

For the ONS’s first year, the group’s objective was to assess existing data sources in France (operations and main characteristics, contributions and limitations) and to develop recommendations for improving these sources.

The topics covered are as follows and are included in the ONS’s first report:

• Suicide statistics: data on suicide mortality

• Suicide surveillance using medical-administrative databases: - PMSI-MCO: data on medical and surgical hospitalizations - RIM-P: psychiatric hospitalizations - Oscour® Network: data on emergency department visits

• Monitoring of suicide history and suicide risk through self-report surveys - General population surveys - Surveys of specific populations

• Data from associations on the topic of suicide

• Suicides and work - Epidemiological surveillance of suicides by occupation - Surveillance of history of suicide attempts and suicide risk by occupation - Epidemiological surveillance of work-related suicides

• Recommendations from discussions within the "surveillance" working group.

Suicide: Current State of Knowledge and Research Perspectives

This report consists of three parts:

• Three sections titled: - Information systems on suicides and suicide attempts - Suicide prevention initiatives - Research on suicidal behavior and its prevention.

• Nine fact sheets present findings derived from data from the information systems discussed in the section. The topics of these fact sheets are as follows: - Epidemiological data on deaths by suicide - Conditions associated with suicides reported in medical death certificates - Hospitalization and emergency room visits for suicide attempts - Reported suicide attempts and suicidal ideation in 2005 and 2010 - Profiles and trajectories of individuals with suicidal ideation according to the Health and Career Path (SIP) survey - Suicide by occupation - Monitoring of suicide mortality among working farmers - Suicide among prisoners in France - Sexual minorities and suicide risk

• Appendices, including a literature review (“The 2008 Crisis and Suicides”) and a digital collection on the topic of suicide.