Suicide Prevention Interventions for Older People in Nursing Homes and Long-Term Care Facilities: A Systematic Review.
BACKGROUND
The death rate due to suicide among older people is high, especially among men. Because many older people live in nursing homes or long-term care facilities in high-income countries, reviewing the impact of prevention strategies on the suicidal behavior of residents in these settings is of interest.


METHODS
Following PRISMA guidelines, we performed a systematic review of the existing literature found in Pubmed, Scopus, Web of Science, PsycINFO, and Sociological Abstracts, focusing on interventions to prevent suicidal behavior or ideation in nursing home residents. The studies' quality was evaluated according to TIDieR and MMAT.


RESULTS
Only 6 studies met the inclusion criteria. Four of them described various "gatekeeper" trainings for nursing home staff and 2 described interventions focused on residents. Only 1 study was randomized. Gatekeeper training studies were mostly before/after comparisons. No intervention demonstrated a direct effect on suicidal ideation or behaviors. One study showed that "life review" had a long-lasting effect on depression scores and another that gatekeeper training led to changes in the care of suicidal residents.


CONCLUSIONS
Interventions to prevent suicidal ideation or behaviors in nursing homes are not rigorously evaluated, and no conclusion can be drawn on their effectiveness in preventing suicidal behaviors. We propose to better evaluate gatekeeper training for staff as well as peer support. Individual interventions targeting residents could be modified for broader implementation.
['Chauliac|Nicolas|N|0000-0002-7503-4796', 'Leaune|Edouard|E|', 'Gardette|Virginie|V|', 'Poulet|Emmanuel|E|', 'Duclos|Antoine|A|']
D000368:Aged D000369:Aged, 80 and over D005260:Female D005852:Geriatric Psychiatry D006801:Humans D008134:Long-Term Care D008297:Male D009735:Nursing Homes D059020:Suicidal Ideation D013405:Suicide D013406:Suicide, Attempted
suicide prevention older people nursing home long-term care geriatric psychiatry