Methods and efficacy of social support interventions in preventing suicide: a systematic review and meta-analysis

Abstract

QuestionSuicide is a global public and mental health problem. The effectiveness of social support interventions has not been widely demonstrated in the prevention of suicide. We aimed to describe the methods of social support interventions in preventing suicide and examine the efficacy of them.Study selection and analysisWe searched literature databases and conducted clinical trials. The inclusion criteria for the summary of intervention methods were as follows: (1) studies aimed at preventing suicide through method(s) that directly provide social support; (2) use of one or more method(s) to directly provide social support. The additional inclusion criteria for meta-analysis on the efficacy of these interventions included: (1) suicide, suicide attempt or social support-related outcome was measured; (2) randomised controlled trial design and (3) using social support intervention as the main/only method.FindingsIn total, 22 656 records and 185 clinical trials were identified. We reviewed 77 studies in terms of intervention methods, settings, support providers and support recipients. There was a total of 18 799 person-years among the ten studies measuring suicide. The number of suicides was significantly reduced in the intervention group (risk ratio (RR)=0.48, 95% CI 0.27 to 0.85). In 14 studies with a total of 14 469 person-years, there was no significant reduction of suicide attempts in the overall pooled RR of 0.88 (95% CI 0.73 to 1.07).ConclusionsSocial support interventions were recommended as a suicide prevention strategy for those with elevated suicide risk.

Can I count on you? Social support, depression and suicide risk

“…After examining randomized controlled trials utilizing social support as treatment, they found a non‐significant result of lowered suicide attempts in the intervention group compared to treatment as usual, while death by suicide was reduced by 53% (Hou et al, 2022). The methods employed by these RCTs included one‐to‐one intervention using postcards, text messaging, face‐to‐face, telephone, or email contact by laypersons or professionals, while group interventions included group meetings or integrated group activities such as hiking or volunteering (Hou et al, 2022). These mixed findings may be due to interventions utilizing professionals or strangers rather than bolstering the existing relationships one has, specifically their family relationships.…”

“…These findings are important to understand the aetiology of suicidality and should be reinforced as specific targets for treatment when dealing with depressed patients at risk of suicidal behaviour. A recent meta-analysis by Hou et al (2022) highlights the inconsistencies in the treatment of suicidality using social support methods. After examining randomized controlled trials utilizing social support as treatment, they found a non-significant result of lowered suicide attempts in the intervention group compared to treatment as usual, while death by suicide was reduced by 53% (Hou et al, 2022).…”

“…A recent meta-analysis by Hou et al (2022) highlights the inconsistencies in the treatment of suicidality using social support methods. After examining randomized controlled trials utilizing social support as treatment, they found a non-significant result of lowered suicide attempts in the intervention group compared to treatment as usual, while death by suicide was reduced by 53% (Hou et al, 2022). The methods employed by these RCTs included one-to-one intervention using postcards, text messaging, face-to-face, telephone, or email contact by laypersons or professionals, while group interventions included group meetings or integrated group activities such as hiking or volunteering (Hou et al, 2022).…”

Sex Differences in Determinants of Suicide Risk Preceding Psychiatric Admission: An Electronic Medical Record Study

“…In any case, our results show that psychosocial factors such as stressful experiences and social relationships are particularly important in screening for elevated suicide risk in males. Moreover, targeted social interventions such as offering social skills training and social support, providing opportunities for positive social engagement, and challenging maladaptive social cognition ( 53 ) may prove beneficial for suicide prevention efforts ( 54 ).…”

Whole-brain structural and functional neuroimaging of individuals who attempted suicide and people who did not: a systematic review, exploratory coordinate-based meta-analysis and seed-based connectivity study

“…SAs are preventable behaviours that usually emerge when individuals think of death as the only option to escape unbearable suffering (Pompili et al, 2008). Although several public health interventions can be put in place to prevent suicide at the population level (Hofstra et al, 2020; Hou et al, 2022; Mann et al, 2021), and psychotherapeutic (Brown et al, 2005; Büscher et al, 2020; Stanley & Brown, 2012) or pharmacological approaches (Baldessarini et al, 2006a; Zalsman et al, 2016) can be successfully implemented at the individual level, clinical tools to predict who is more likely to attempt suicide are somewhat limited, and mainly subject-dependent (Haney et al, 2012). In this context, neuroimaging markers bear the essential properties of representing fruitful objective measures of one’s risk of death by suicide (Sudol & Mann, 2017).…”