Suicide is a huge but largely preventable public health problem, causing almost half of all violent deaths and resulting in almost one million of fatalities every year. In North America and most European countries, suicide has ranked among the top 5-10 causes of death for many years. There are also economic costs in the billions of dollars. Globally, suicides represent 1.4% of the Global Burden of Disease, but the losses extend much further. Thus, any issue related to suicide prevention has become an important issue of population health responsibility [1].

Identifying the chain of causal and triggering factors - which may in any case be highly individual - and deriving from this an overall prevention strategy is one of the most challenging problems facing professionals in the health sciences [2]. The complexity of the interaction between risk factors, and the capacity for health care and social interaction to influence individuals’ choices, suggests that government and society have a responsibility to act [3].

However, there is always a question of reliability whenever figures of suicide are presented or discussed. Real figures may be higher, because suicide as a reason of death can be hidden: some deaths categorized as accidental may hide suicides due to taboo, to limit psychological burden on survivors, or even to avoid loss of life-insurance payments. Sometimes deaths occurring a few days after a suicide attempt are attributed to the final cause rather than considered a delayed outcome of a suicidal act [4] . Given the importance of the problem, it is ironic that no national surveillance system for suicide exists in Malaysia. In contrast, the government had supported extensive data collection efforts for the past two decades to record about other leading causes of death e.g. fatalities due to road accidents. The Ministry of Health Malaysia (MOH) and others are aware of the long-standing gap in information about suicide, and had been pressing the need for a national surveillance system. In the hospital division, discrete efforts had been carried out by Forensic Medicine and Psychiatry departments to track and trend the suicide cases handled by their respective departments. The psychiatrists had taken it one step further: the Annual Psychiatrists (Ministry of Health) Meeting in Putrajaya in 2005 had unanimously agreed to develop a national suicide registry to aid efforts in managing mental health problems related to suicides. Meanwhile, the National Suicide Prevention Action Plan initiated by the Mental Health Unit of the Public Health arm of the MOH had also pointed out the importance of having surveillance data to guide planning and gauge the success of suicide prevention programs. In late 2005, the Psychiatry and Forensic Medicine Programs of the Ministry of Health, with assistance from the Violence and Injury Prevention Unit from the Non Communicable Disease Department of the MOH had set up a Joint Technical Committee to explore the feasibility of creating a nationwide suicide registry. A pilot study had been carried out in three hospitals: Hospital Kuala Lumpur, Hospital Tengku Ampuan Afzan Kuantan and Hospital Sultanah Aminah Johor Bahru. Following that, a national-level meeting was carried out on 24 – 27 July 2006 with representatives from the Forensic Pathology, Psychiatry and Accident and Emergency Departments from all state hospitals and major universities. Based on feedbacks from participants, some changes had been made to the original Suicide Report Form and implementation plans for the suicide registry project was finalized. This document will reflect the changes that had been made and aid in the completion of the form.Beginning in 2007, the NSRM had received a special funding from the Ministry of Health via the Clinical Research Centre to implement this program as a clinical registry project.