Are Suicide Prevention Interventions Effective for Current and Ex-Serving Military Personnel? A Systematic Review and Meta-Analysis Based on the Suicide Prevention Trials Database.

Abstract

Introduction: Suicide rates remain elevated for current and ex-serving military populations, yet the effectiveness of suicide interventions for these populations is unclear. Therefore, a synthesis and analysis of interventions is needed. This systematic review and meta-analysis aims to identify which interventions may be effective for suicidal ideation and behaviors among current and ex-serving military personnel.

Method: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Datasets were drawn from the Suicide Prevention Trials Database. Meta-analyses of randomized controlled trials were conducted using standardized mean change for suicidal ideation and pooled log odds ratio for suicidal behaviors.

Results: In total, 24 studies were eligible. Most studies were randomized controlled trials (n = 17) from the United States (n = 21) and comprised indicated interventions (n = 17). Meta-analyses found no significant pooled effects for suicidal ideation and behaviors. Moderation analyses found that care management, follow-up, or monitoring; and nonpharmacological biological interventions were more effective than behavioral interventions for suicide attempts. Selective, multicomponent interventions demonstrated encouraging outcomes.

Conclusion: The review found no evidence of overall effects for the current interventions on suicidal ideation and behaviors. Future interventions should be based on suicide theories and co-developed with individuals with military and suicidality lived experience.