Int. J. Environ. Res. Public Health 2012, 9 29 between the magnitude of the problem of suicide in the society in general and the attitudes towards postvention. She suggested that “it would be interesting to know how the level of suicide in a society relates to the attitudes towards suicide survivors. Does the frequency of suicide help or hinder positive reactions towards suicide survivors?” ([10], p. 357). Unfortunately, to-date there have been no studies tackling this important public health issue. The evaluation of postvention programs is another important, albeit relatively neglected, public health challenge. A recent pioneering example of such a health-economic evaluation is the study of the Australian StandBy Response Service, a community-based outreach program providing support and a coordinated response for people bereaved through suicide [41]. The evaluation showed that the service appeared to reduce the negative impact of suicide bereavement on physical and mental health, including lower levels of suicidality, particularly within the first two years after the loss. In comparison to survivors who did not participate in the program, the StandBy clients reported higher levels of productivity both in terms of absenteeism and presenteeism (work attendance accompanied by low performance levels) and less frequent use of health care services, such as medical specialists and hospitals. Last but not least, the service saved society an average of AUD800 per person bereaved by suicide. Needless to say, such health-economic evaluations are much needed to provide evidence convincing private and public sponsors to further contribute to the building of “benign communities”. 5. Postvention as Suicide Prevention and Directions for the Future Suicide survivors comprise not only the target group of postvention activities; they are also an active force behind many suicide prevention initiatives, such as Suicide Prevention Action Network USA, Lifekeeper Memory Quilt in Australia and the Media Award for Responsible Portrayal of Suicide in Belgium. In the words of Paul Quinnett, “the suicide prevention movement has not been powered by rhetorical interest, but by the pain of those who have lost loved ones” (personal communication, AAS Suicidology List, 4 April 2011). Also, given the fact that suicide survivors are a group with increased suicide risk, postvention is an integral and indispensable component of comprehensive suicide prevention programs. Just as suicidology without the involvement of survivors would be poor suicidology, suicide prevention without survivors would be poor suicide prevention. The voice of survivors should be included in public health policies related to suicide prevention as well as involved in design and implementation of postvention programs and studies, although a detailed discussion of this issue is beyond the scope of this paper [17]. There is also a growing consensus in regards to the international policy and research agenda to ensure further progress in the field of postvention in the upcoming decades [2,42]. The major points include: (a) formulation of operational and consensus definitions of “a suicide survivor” and “postvention” and conducting further studies to establish the number of individuals affected by suicide (both survivors and people exposed to suicide), (b) conducting methodologically sound studies in order to identify the specific experiences and needs of various subgroups of survivors based upon age, gender, closeness and type of the relationship with the deceased, including cross-cultural research, and (c) conducting effectiveness studies of postvention activities, with a special focus on suicide support groups and public health policies, including health-economic studies.