JMIR Publications

ABSTRACT

Background:

The Coopération Québec-France contre la dépression et l'isolement (CQFD-I) initiative represents a collaborative effort from a region in Québec, Canada, (i.e., Outaouais), and a metroplitain aera in France, (i.e., Brest), to reduce suicide through a multimodal approach. CQFD-I integrates five key strategies: a web portal on depression, education of primary care physicians on depression, training for mental health professionals in suicide risk assessment and management, and standardized follow-up protocols for individuals after a suicide attempt

Objective:

To evaluate the effectiveness of CQFD-I in reducing outcomes related to suicidal behavior, namely suicide mortality, hospitalizations due to suicide attempts, and emergency room visits for suicide attempts, across the implementation sites compared to control areas.

Methods:

The evaluation will utilize a controlled interrupted time series design, spanning three distinct phases: pre-implementation (2015-2020), implementation (2020-2022), and post-implementation (2022-2024). Intervention sites in both Québec and France will be matched with control non-exposed areas within the same jurisdictions. The analysis will focus on age- and sex-adjusted monthly rates of the specified outcomes, with an emphasis on changes in rates across the study phases to assess the putative effectiveness of the CQFD-I intervention.

Results:

This project is funded by the ministère de la Santé et des Services Sociaux du Québec, with access to data and expertise representing in-kind contributions from Santé publique France and INSPQ. Under the responsibility of the first author, data will be collected in September 2027 to account for the delays necessary to confirm suicide deaths in official registers.

Conclusions:

To our knowledge, this study will be the first to document the outcomes of a multimodal suicide prevention program targeting geographically defined areas within two countries not limited to the European Union.