Suicide Risk Help-Seeking Among Middle- to Old-Age Adults: A Systematic Review

Abstract

Background and Objectives Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults. Research Design and Methods Using PRISMA guidelines, electronic databases, and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010-2020. A total of 4,732 unduplicated publications were screened for relevance based on titles and abstracts and of which, 52 were reviewed in full text. Results 24 articles met inclusion criteria and were included in qualitative synthesis. These articles discussed a range of topics, including prevalence of service utilization, service use prior to suicide death, and correlates of help-seeking. In general, prevalence of service utilization was low and varied by suicidal history (e.g., higher prevalence among individuals with a history of suicide attempt than those with suicide ideation only). Key facilitators (e.g., current or history of suicidal thoughts, plan, or attempt) and barriers (e.g., stigma) for service use and help-seeking were also identified. Discussion and Implications Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.

Physical Health Problems as a Suicide Precipitant: Associations With Other Risk Factors and Suicide Methods in Three Age Groups of Older Decedents

“…Despite their elevated depressed mood, only a small proportion of those with PH received any mental health treatment within the preceding 2 months of their death. Our finding is consistent with a recent systematic review that showed low rates of suicide risk help-seeking and service utilization among middle-aged and older adults ( Wang et al, 2023 ). Treatment nonreceipt may have been in part due to unaffordability and other barriers to accessing care (e.g., transportation, provider unavailability, stigma, mistrust of treatment providers; NCIPC, 2021 ; Wang et al, 2023 ).…”

“…Our finding is consistent with a recent systematic review that showed low rates of suicide risk help-seeking and service utilization among middle-aged and older adults ( Wang et al, 2023 ). Treatment nonreceipt may have been in part due to unaffordability and other barriers to accessing care (e.g., transportation, provider unavailability, stigma, mistrust of treatment providers; NCIPC, 2021 ; Wang et al, 2023 ). Of those who were in treatment, non-adherence to treatment regimen or premature termination may have been a problem ( NCIPC, 2021 ).…”