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From early detection to care: How Uruguay Is transforming suicide prevention through real-time surveillance [1]
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Date: 2025-08
Uruguay, a country of just over 3 million people, is among the countries in the Americas with the highest suicide rates. Recognizing that previous suicide attempts are a strong risk factor for future suicide, Uruguayan health authorities have made it a national priority to improve the way these events are detected and followed up. Its recent launch of a nationwide digital registry system is enabling faster, more accurate responses to suicidal behavior – and offering valuable insights that are informing both clinical care and public health policy.
From Paper to Digital: Building a National Surveillance System
Uruguay’s journey toward a robust surveillance system began with the implementation of a paper-based registry in 2013. While this was an important first step, it had limitations – particularly in timeliness and usability. In 2022, the Ministry of Public Health launched a nationwide digital suicide attempt registry, making it mandatory for all 97 emergency departments (EDs) across the country to register every suicide attempt presenting to an ED within 24 hours of the event.
This digital system was developed by an operational group within the Ministry, led by professionals from the National Mental Health Department. A technical advisory group of clinicians, academics, and health administrators helped determine which data variables were most important – balancing epidemiological value with clinical feasibility. Insights were also drawn from international experiences and from the WHO Practice manual for establishing and maintaining surveillance systems for suicide attempts and self-harm (For Spanish translation see here).
The system was designed to be concise and practical, minimizing the burden on already stretched ED staff. An evaluation found that on average registration took just five minutes.
Nation-wide Implementation
To ensure seamless implementation, a dedicated team comprising the Ministry’s e-government, mental health, and health surveillance departments coordinated with healthcare providers across the country to deliver training for accurate and timely data entry. A comprehensive, multi-layered quality assurance process has been established. The data once entered is initially validated by a mental health specialist and reviewed daily by the surveillance department of the Ministry. Quarterly audits are further conducted to assess completeness and identify gaps.
From Early Detection to Targeted Follow-up Care
The benefits of Uruguay’s system are already being felt. On the clinical front, authorised mental health professionals can access real-time data on recent suicide attempts, enabling rapid follow-up, consistent with WHO LIVE LIFE guidance for suicide prevention. Furthermore, Uruguay’s national clinical guidelines for the management and follow-up of individuals with suicide attempts mandates all individuals presenting to the ED should be followed up by a trained mental health professional — such as a psychiatrist, psychologist, or mental health specialist nurse — within 48 hours and 7 days post-attempt. The surveillance system and daily quality assurance reviews supports adherence to this clinical protocol. In this way, the national surveillance system and clinical guidelines are complementary mechanisms promoting timely intervention and continuity of care.
Credit: Ministry of Public Health, Uruguay.
Impact at the Policy Level
At the policy level, the system provides rich data on the demographics and circumstances of suicide attempts. Policymakers are using these insights to monitor trends, assess variations across time and regions, and tailor interventions to high-risk populations.
“Having timely, reliable data has transformed the way we work,” says the team from the National Mental Health Department of the Ministry of Public Health. “It allows us to work more closely with healthcare institutions across the National Health System, strengthen the quality of mental health care, and ensure timely, coordinated responses for those at risk. At the same time, it guides the design of multisectoral policies grounded in national evidence, helping us move from reactive measures to proactive prevention.”
By establishing a national infrastructure for real-time monitoring, Uruguay is laying the foundation for smarter prevention – grounded in evidence, collaboration, and rapid response. The data is already informing the design of Uruguay’s next national suicide prevention strategy.
Credit: Ministry of Public Health, Uruguay.
Lessons for the Region and the World
Uruguay stands out as a regional and global leader in real-time surveillance of suicide attempts, and offers a compelling model for other countries seeking data-driven public health approaches to suicide prevention. Critical success factors include: high-level political commitment and mandates, technical collaboration across sectors, simple and user-friendly tools, strong quality assurance processes, and continuous engagement with healthcare providers.
While no system or intervention alone can prevent suicides, Uruguay’s national surveillance registry linked to clinical guidelines for suicide attempts, marks a major step forward. By capturing the warning signs early, connecting people to care, and providing decision-makers with timely information, Uruguay is proving that well-functioning surveillance isn’t just about numbers – it’s about saving lives.
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[1] Url:
https://www.who.int/news-room/feature-stories/detail/from-early-detection-to-care--how-uruguay-is-transforming-suicide-prevention-through-real-time-surveillance
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