A controlled trial comparing a treatment algorithm plus depression care management with treatment as usual for late-life depression in primary care in the United States demonstrated greater improvement in patient suicidal ideation and a more favorable course of illness in the intervention group compared with the treatment-as-usual group.31 An adolescent depression treatment quality improvement intervention with care managers supporting primary care physicians resulted in a 50% decrease in suicide attempts in the intervention group that was not statistically different from the control group (18%) due to the low base rate.42 An Australian program that trained primary care physicians to recognize and respond to psychological distress and suicidal ideation in young people increased identification of suicidal patients by 130% (determined by the Depressive Symptom Inventory–Suicidality Subscale score), without changes in treatment or management strategies.64 Studies examining suicidal behavior in response to primary care physician education programs, mostly targeting depression recognition and treatment, in specific regions in Sweden,66,118 Hungary,47 Japan,65 and Slovenia48 have all reported increased prescription rate for antidepressants and often substantial declines in suicide rates and represent the most striking known example of a therapeutic intervention lowering suicide rates.