The Search for a Suicide Cure Continues

Suicide screening and prevention tools needed to lower rates in the US

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) New strategies to prevent suicide in the United States are needed. Teenagers are a particularly tough age group to reach. Researchers continue to strive for solutions.

A recent review looked at a large body of evidence in search of tools that could help primary care providers screen for suicide risk in adults and adolescents and help develop treatment plans to prevent suicide attempts.

The results showed that no effective screening tools have been developed.

Therapy appears to improve suicide rates in high-risk adults, but not in adolescents.

"Thoughts of suicide? Talk to a therapist."

Elizabeth O’Connor, PhD, research associate for Kaiser Permanente Research, a healthcare provider program in Northern California and Oregon, led a team of researchers to investigate effective screening tools for suicide prevention into primary healthcare settings.

The results of this study were intended to inform the US Preventive Services Task Force.

“Suicide was the 10th leading cause of death in the United States in 2009, accounting for 36,897 deaths,” said the study authors.

Many US adults (38 percent) had visited a primary care provider within one month prior to committing suicide.

Among adolescents who committed suicide, nearly 90 percent had visited a primary care provider in the previous year. In comparison, 70 to 80 percent of adolescents that did not commit suicide visited a primary care provider.

For this study, the research team set out to investigate ways to identify teens at risk for a possible suicide attempt.

The researchers looked through multiple medical databases between 2002 and 2012 for studies and trials aimed at screening for or treatment of suicide risk.

A total of 56 studies were selected, seven of which tested screening methods and 49 of which measured the benefits of treatment in adults or adolescents.

Unfortunately, the results did not provide enough solid evidence for the researchers to develop an acceptable screening tool or treatment plan for the US Preventive Services Task Force.

The researchers said that limited evidence pointed to a lack of harm from screening in a primary care setting.

The study authors also found a small amount of evidence that screening tools in a primary care setting could help identify some adults that were at an increased risk for suicide.

Trials on adolescents were limited to high-risk populations, which did not represent the general population. In addition, the adolescent trials did not show that screening tools worked well among this age group.

Psychotherapy appeared to help reduce suicide attempts in high-risk adults by roughly 32 percent, but not in adolescents.

There was not enough evidence from the trials to determine whether the screening tools or treatment attempts significantly reduced actual suicide rates.

“Primary care-feasible screening tools might help to identify some adults at increased risk for suicide but have limited ability to detect suicide risk in adolescents,” the authors concluded.

“Psychotherapy may reduce suicide attempts in some high-risk adults, but effective interventions for high-risk adolescents are not yet proven,” they continued.

The study authors recommended further research into effective types of screening for suicide and for types of therapy to prevent suicide.

This study was published in April in the Annals of Internal Medicine.

The Agency for Healthcare Research and Quality and the Oregon Evidence-based Practice Center funded this project. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 26, 2013
Last Updated:
November 8, 2013