Impact of interventions at frequently used suicide locations on occurrence of suicides at other sites: a systematic review and meta-analysis.

Abstract

Background: Interventions at frequently used suicide locations that restrict access to means, encourage help-seeking, and increase the likelihood of intervention by a third party are effective in preventing suicide at such sites. However, there have been concerns that such efforts may displace suicides to other sites. It is important to synthesize the evidence on suicide displacement effects.

Methods: We conducted a systematic search of Medline, PsycINFO, Scopus, and Google for eligible studies from their inception to February 20, 2025. Meta-analyses were conducted to assess the pooled effects of interventions on suicides at frequently used locations and other sites, and on overall suicides involving the same method.

Results: Our search identified 17 studies. Meta-analyses showed a reduction in suicides at the intervention sites (pooled incidence rate ratio [IRR] 0.09, 95% confidence interval [95% CI] 0.04-0.21) and no evidence of changes in suicides at other sites after restricting access to means was deployed alone. The pooled IRR for nearby sites (same type) was 0.99 (95% CI 0.72-1.38); for other sites (same type), it was 0.99 (95% CI 0.76-1.29); and for other sites (different/unspecified type), it was 1.19 (95% CI 0.90-1.58). There was an overall reduction in suicides involving the same method during the post-intervention period (IRR 0.77, 95% CI 0.65-0.92). Similar patterns were observed when restricting access to means was assessed alone or with other interventions.

Conclusions: Suicide numbers at other sites did not change after interventions such as restricting access to means were deployed at frequently used locations.