Suicidal behaviours are public health problems that should be addressed through a systematic public health approach. The need for such an approach is discussed using data from Pierre, South Dakota, where the suicide rate is 13 times the national rate; in the African American community where the suicide rate among black youths more than doubled between 1980-95; & across the United States, where suicides outnumbered homicides in 1995. The four steps in a public health approach are described.