This study aims to systematically evaluate the effectiveness of Seoul’s major suicide prevention programs and provide foundational evidence for advancing evidence-based suicide prevention policies. Three key programs encompassing the full spectrum of suicide prevention were assessed: (1) the Life Keeper Training Program, (2) the Primary Care-based “Saengmyeongeum Stethoscope” Program, and (3) the Suicide Attempter Registration and Case Management Program.
The Life Keeper Training Program significantly improved citizens’ gatekeeper competencies, including suicide literacy, preparedness, and self-efficacy. More than 20% of participants reported encountering individuals with suicidal intent and actively engaging in gatekeeper behaviors. These findings highlight the need to expand citizen-based education and establish regular retraining systems to sustain behavioral practice. The Saengmyeongeum Stethoscope Program revealed structural challenges, such as insufficient guidance during screening, delays in referral between clinics and public health centers, and limited effectiveness of short-term counseling. Enhancing program efficacy requires stronger medical participation, a real-time digital referral system between primary care and public health centers, and the development of a continuous case management model with follow-up counseling and monitoring. The Suicide Attempter Registration and Case Management Program identified stigma, distrust of public services, and non-standardized linkage procedures as key factors reducing community referral rates. To address these issues, the study recommends standardizing referral protocols, expanding professional staff and improving counseling environments, and establishing tailored multi-agency linkage systems.
Collectively, these findings underscore the importance of institutionalizing a sustainable and cyclical evaluation framework that integrates regular program assessments and policy feedback. Such a system will enable Seoul to strengthen the sustainability and credibility of its suicide prevention policies and advance toward an evidence-based “Safe City for Life.”