Population- and Community-Based Interventions to Prevent Suicide

Abstract

Abstract. Background: Suicide is estimated to account for 1.4% of deaths worldwide, making it among the leading causes of premature death. Public health approaches to reduce suicide have the potential to reach individuals across the spectrum of suicide risk. Aims: To review the effectiveness of newer community-based or population-level suicide prevention strategies. Methods: We conducted a systematic review of literature published from January 2010 to November 2020 to evaluate the effectiveness of community- and population-level interventions. The US Center for Disease Control framework was used for grouping studies by strategy. Results: We included 56 publications that described 47 unique studies. Interventions that reduce access to lethal means, implement organizational policies and culture in police workplace settings, and involve community screening for depression may reduce suicide deaths. It is unclear if other interventions such as public awareness and education campaigns, crisis lines, and gatekeeper training prevent suicide. Evidence was inconsistent for community-based, multistrategy interventions. The most promising multistrategy intervention was the European Alliance Against Depression. Limitations: Most eligible studies were observational and many lacked concurrent control groups or adjustment for confounding variables. Conclusions: Community-based interventions that may reduce suicide deaths include reducing access to lethal means, implementing organizational policies in workplace settings, screening for depression, and the multistrategy European Alliance Against Depression Program. Evidence was unclear, inconsistent, or lacking regarding the impact of many other single- or multistrategy interventions on suicide deaths.

Demographics and risk factors for suicide in Syria: A retrospective media content analysis of online news sources

“…This approach would provide deeper insights into the contextual nuances of suicide risk factors in Syria by capturing personal experiences and cultural perceptions that this study could not address. Future research would also benefit from community-based participatory research approaches, which involve community members in the research process ensuring their voices are heard and that findings lead to interventions tailored to the specific needs of the population (Colucci et al, 2022 ; Linskens et al, 2023 ). This is crucial for culturally sensitive and contextually relevant research, especially in fragile contexts like Syria.…”

Overcoming treatment gaps in the management of depression with non-pharmacological adjunctive strategies

“…Multilevel and multifaceted interventions are another approach. The community-based 4-level intervention from the EAAD which simultaneously addresses depression and suicidality, has been identified as the most promising multifaceted and evidence-based intervention by a recent systematic review ( 68 ). It combines evidence-based prevention, education and treatment methods that are tailored to the needs and resources of local communities ( 53 , 69 ).…”

“…A number of exciting research projects are emerging on these topics, and the number of models which possibly contribute to depression (and its prevention) is increasing. What all these new models have in common is that they are complex and emphasize the profiling of multiple factors ( 68 , 70 , 79 , 83 , 84 , 87 ). Approaches that focus on the role of a single factor (e.g., a particular substance or a single psychological model) are likely to be less successful in the future understanding of depression.…”

“…Treatment response in this approach, goes beyond reduction and functional recovery to take account of exacerbations, relapses and other specific indicators such as hospital admissions, number of psychotropic medications and selfharm behavior (79)(80)(81)(82). Evaluation of the multimodal approach and incorporation of predictive measures may also be feasible in naturalistic studies (82,83) and multifaceted community interventions (68)(69)(70).…”

Community mental health services may be life-saving for middle-aged and older adults with hospital-treated intentional self-harm

“…Several types of community-based interventions have shown promise for reducing rates of death by suicide. These include caring letters after hospital discharge (Motto and Bostrom, 2001), safety planning (Ferguson et al, 2022), as well as screening for depression, implementing workplace-based strategies, and restricting access to lethal means (Linskens et al, 2023), among others. Since most people who die by suicide meet criteria for a psychiatric diagnosis, however, it is also worth noting that individuals with psychiatric disorders have higher rates of all-cause mortality than do those without such disorders and they are, in fact, more likely to die from physical illness than from suicide (Kisely et al, 2013).…”