To clarify the prevalence of depression in a rural community in Japan and to evaluate the social and familial risk factors for depression, with the goal of suicide prevention, a questionnaire survey was conducted on a total of 2,763 elderly persons. The determined prevalence of depressive symptoms (Zung's self-rated depression scale score of 50 points or more) was 10.4%. Logistic regression analysis showed associations between depressive symptoms and age, absence of a friendly companion, irritation with one's family, frequent loneliness, the opinion that stress has a large impact on one's life, suicide ideation, and poor subjective physical and mental health.

A community-based intervention study for suicide prevention was conducted in six towns (total population 43,964) in Akita Prefecture of Japan according to a quasi-experimental design to reduce suicide rates in rural towns. Public awareness raising activities using a health promotion approach emphasizing the empowerment of residents and civic participation were conducted. The welfare measures of promoting a sense of purpose among senior citizens and creating a community network were also taken. As a result, the suicide rate per 100,000 in the intervention towns decreased from 70.8 before intervention (1999) to 34.1 after intervention (2004). The suicide rate per 100,000 in the control towns was 47.8 before intervention and 49.1 after intervention.

Suicide prevention programs at a national level in developed countries were briefly reviewed, and the community-based suicide prevention programs in Akita Prefecture, in the Tohoku Region of Japan, were also outlined. Suicide prevention programs were proposed in Western countries in the 1980s. A famous example is the national prevention program in Finland that was started in 1986. The national suicide prevention programs in Western countries share some common features such as their comprehensiveness and diversity. Typical policies of suicide prevention programs were categorized according to primary, secondary and tertiary prevention. Regarding community-based suicide prevention programs using a health promotion approach, the Akita prefectural government incorporated a suicide prevention program into the local health promotion strategy "Health Akita 21" in 2001. An outline of the four action programs was as follows: to raise awareness of suicide prevention, to increase opportunities for mental health consultation, to promote both primary and secondary prevention of depression, and to create a supportive environment for mental health promotion. Community-based suicide prevention programs were started in some communities of model projects that are financially supported by Akita Prefectural government. Efforts to evaluate the effectiveness of community-based suicide prevention programs are needed in the future.

Objective: This study was conducted to examine the conditions and characteristics of older adults who use short-stay services as well as those of their primary caregivers by categorizing them into long-term use and short-term use groups. Patients and Methods:We conducted logistic regression analyses on the data of 679 short-term residential care (short-stay) users using the χ 2 test, with the type of use as the dependent variable. Results:The results of the comparison show that users in long-term care were likely to be men, ≥95 years old, live alone, and require care for severe dementia (level three or more). Primary caregivers lived farther away from the user's neighborhood, felt burdened by and lacked knowledge about providing care, and preferred that the patient continue to receive care in a facility or be hospitalized. Conclusion:It was suggested that care support specialists in charge of elderly persons requiring severe nursing care who live alone may be adjusting to the long-term use of short stays, which is not usually expected, because they are influenced by the nursing care burden of the primary caregiver who lives far away, the level of knowledge and skills of nursing care, and the primary caregiver's willingness to continue caring, and because they cannot immediately enter a facility when they are no longer able to live alone.