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Meta-analysis shows efficacy of suicide hotspot interventions

A meta-analysis published in Lancet Psychiatry showed that interventions aimed at reducing suicides at suicide hotspots, either by restricting access to means, encouraging help-seeking or increasing likelihood of intervention by a third party, were effective.

“Suicide hotspots are specific, accessible, and usually public sites which are frequently used as locations for suicide and gain reputations as such. Some hotspots offer the means of suicide, usually by jumping. Others offer seclusion, making it unlikely that a suicide attempt will be interrupted and increasing the chance that it will be fatal. In metropolitan areas, suicide hotspots tend to be bridges, tall buildings, car parks, and railway tracks. In less built-up areas, they are more likely to take the form of cliffs and woodland areas,” Jane Pirkis, PhD, of the Centre for Mental Health at the Melbourne School of Population and Global Health, Australia, and colleagues wrote.

To assess effectiveness of interventions introduced to prevent suicides at suicide hotspots, Pirkis and colleagues conducted a meta-analysis of 18 studies on interventions that restricted access to means, encouraged help-seeking or increased the likelihood of intervention by a third party.

Interventions that restricted access to means were associated with a reduced number of suicides per year (IRR = 0.09; 95% CI, 0.03-0.27; P < .0001), as were interventions that encouraged help-seeking (IRR = 0.49; 95% CI, 0.29-0.83; P < .0086) or increased the likelihood of intervention by a third party (IRR = 0.53; 95% CI, 0.31-0.89; P = .0155), after removing one outlier.

When analyzing studies that included an intervention in isolation, restricting access to means was associated with a reduced risk for suicide (IRR = 0.07; 95% CI, 0.02-0.19; P < .0001), as was encouraging help-seeking (IRR = 0.39; 95% CI, 0.19-0.8; P = .0101). No studies assessed solely interventions that increased the likelihood of intervention by a third party.

“Blocking access to a hotspot can serve as an expression of important values, if done in a way that builds community awareness and support for broader efforts to prevent suicide, attempted suicide, and antecedent risks,” Eric D. Caine, MD, of the University of Rochester in New York, wrote in an accompanying editorial. “However, given the small numbers involved, blocking access to suicide hotspots should be part of an overall regional or national approach to suicide prevention, which together constitutes a well-considered, carefully implemented strategy intended to generate sustained measurable effects.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.