Analysis of the impact of the Brazilian Suicide Prevention Campaign "Yellow September": an ecological study

Abstract Objective: Yellow September (YS) (Setembro Amarelo) is a Brazilian suicide prevention campaign launched in 2015, however, its effectiveness at reducing mortality is still unknown. This is an ecologically interrupted time series study that analyzed the trend in suicide rates in Brazil between 2011 and 2019 and its association with the implementation of YS at a national level. Methods: A segmented interrupted series regression analysis was performed, using a generalized linear Poisson model, with correction for seasonal trends. Data were provided by the Mortality Information System (Sistema de Informações Sobre Mortalidade [SIM]). Results: There was an increase in the annual rates of suicide deaths between 2011 and 2019, with 4.99 and 6.41 suicides per 100,000 inhabitants, respectively. The null hypothesis, that the YS did not change the historical trend of growth in suicides in Brazil after its implementation, was confirmed. However, there was a significant increase of 6.2% in the risk of mortality in 2017 and a significant increase of 8.6% in 2019. Conclusion: The results are consistent with the literature, which proposes that campaigns focused solely on publicity in the media generate unsound findings regarding the effective reduction in the number of deaths by suicide. The lack of initiatives involving multisectoral actions may explain the failure of YS to change rates of death by suicide. Therefore, implementation of new lines of action focused on training professionals and expanding the care network could make it an effective instrument for reducing mortality from suicide.