What Interventions Help to Prevent Suicide?

Every suicide is heartbreaking, leaving loved ones wondering what went wrong and how they could have prevented such a tragedy.

And yet suicide rates are currently at their highest level since World War II, according to the U.S. Centers for Disease Control. In 2017, there were more than 47,000 recorded suicides in the U.S. – a 33 percent increase compared to 1999.

But what can we do about the devastating problem of suicide?

A systematic review published last month in the Annals of Internal Medicine attempts to answer that question. The review authors combined research from 23 studies to better understand the benefits and harms associated with interventions designed to prevent suicide in adults. Here is what they found:

  • A program sponsored by the World Health Organization significantly reduced the rate of suicide among participants. The program, called Brief Intervention and Contact, includes an educational session on suicide prevention and then regular phone calls with a trained mental health provider for up to 18 months.
  • Positive results were found for another initiative, Crisis Response Planning, which is a brief intervention between someone who is suicidal and a trained individual. It involves writing out a checklist to follow whenever the person feels emotionally overwhelmed including self-management strategies, reasons for living and contact information for social and professional support.
  • Cognitive behavioral therapy – a type of talk therapy where a therapist works with a patient to challenge negative thoughts – helped to reducing suicide attempts, thoughts about suicide and feelings of hopelessness. But the evidence — although weak — showed the therapy did not ultimately prevent suicides.
  • Dialectical behavior therapy, or DBT, is another kind of talk therapy that strives to teach people how to live in the moment, cope with stress and regulate their emotions. Studies of this type of therapy found some evidence that it reduced thoughts about suicide.
  • A final intervention program called Window to Hope was designed for veterans with moderate to severe traumatic brain injury. This program reduced feelings of hopelessness, but not thoughts about suicide.

The review also looked at medicines used to treat depression in patients at risk for suicide. It found that two medicines – a single dose of intravenous ketamine and lithium for patients with mood disorders – reduced suicidal thoughts and actual suicides.

“Effective intervention for suicidal individuals rests on effective detection,” said Janis Whitlock, a research scientist at the BCTR whose work focused on mental health. “Far too many people with serious suicidal impulses never receive any form of treatment. Actively deploying any of the interventions described in this meta analysis rests on rapid detection and on accessible treatment options. All of us can help look out for each other by understanding early warning signs and by knowing how to help vulnerable people access care.”

The take-home message is that, although suicide is a growing problem today, there are effective prevention interventions that can ultimately help people who consider suicide to feel more hopeful about their lives.

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