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Community‐based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females

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OYAMA, HIROFUMI, WATANABE, NAOKI, ONO, YUTAKA, SAKASHITA, TOMOE, TAKENOSHITA, YUKA, TAGUCHI, MANABU, TAKIZAWA, TOHRU, MIURA, REIKO +1 more·2005·Psychiatry and Clinical Neurosciences
DOI 10.1111/j.1440-1819.2005.01379.x
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Abstract

Abstract The lack of social support is the most common risk factor for late‐life suicide. Few previous community‐based interventions against the lack of social relationships reduced suicide. This study aims to evaluate outcomes of a community‐based prevention program against suicide amongst the elderly in rural Japan. During 1995–2002, the program based on population strategy including group activity, psychoeducation and self‐assessment of depression but no screening for depression, was implemented for elderly residents in Yuri town, Japan (5‐year average population 6817; 5‐year average suicide rate [≥65 years old] 291.4/10 5 ). Changes in the relative risk of suicide for individuals (≥65 years old) before and after the 8‐year implementation were estimated by the incidence rate ratio (IRR), using a quasi‐experimental design with a neighboring reference, Chokai town, Japan (5‐year average population 8136; 5‐year average suicide rate [≥65 years old] 216.5/10 5 ). The risk of elderly females in Yuri completing suicide was reduced by 76% (age‐adjusted IRR, 0.24; 95% CI, 0.10–0.58), while there was no change in the risks for Yuri's elderly males and both Chokai's elderly males and females. General loglinear analysis estimated a ratio of the female IRR in Yuri to that in its Akita prefecture of 0.35 (95% CI, 0.14–0.84), showing that the reduction of the risk in the intervention area was greater than a historical trend. A community‐based suicide prevention through a group intervention designed to increase knowledge and to cultivate social relationships would be effective for elderly females but not males.

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  • Screening for suicide risk coupled with effective referral for evaluation and treatment was found by some studies to prevent suicidal behavior.

    “Screening for suicide risk to identify otherwise undetected at-risk individuals,(30, 37) if coupled with effective referral for evaluation and treatment, was found by some studies to prevent suicidal behavior.(15–17, 37, 38)”

    From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [15]

    The Introduction (page unavailable) reports that earlier programs combining depression screening with psychiatric follow-up reduced suicide rates among older adults. It does not establish that screening specifically for suicide risk, coupled with effective referral, produced that result; the paper says its own group intervention was not a screening program. (LLM, conf=0.85)

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  • In areas with suicide rates 3-10 times higher than the U.S., screening for depression combined with referral for depression treatment by a primary care doctor or psychiatrist lowered suicide rates relative to a contemporaneous geographic control.

    “Areas with suicide rates 3–10 times higher than the U.S., have shown that screening for depression combined with referral for depression treatment by a primary care doctor or psychiatrist lowered suicide rates relative to a contemporaneous geographic control.(12, 15–17)”

    From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [15]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • Training primary care doctors and nurses to better screen and treat depression, with supplemental psychiatric help, lowered suicide rates.

    “Training primary care doctors and nurses at the local and state level to better screen and treat depression with supplemental help available from psychiatrists, lowered suicide rates,(12–19) nonfatal suicide attempts(20, 21) and ideation(22) (Table 2).”

    From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [15]

    The Discussion reports that the suicide rate fell among elderly females following the intervention. But it describes the intervention as group activities, psychoeducation, and self-assessment of depression—not training primary care doctors and nurses to screen and treat depression. The Self-assessment section explicitly says the questionnaire was used to recommend assessment, “but not to screen.” (LLM, conf=0.88)

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Research works printed but not linked: 5

  1. [12]12. Muraoka Y, Ikuchi A, Ihara K. Physical, psychological and social factors of depressed older residents in the community. Jpn. J. Geriatr. Psychiatry 1996; 7: 397-407 (in Japanese).
  2. [13]13. Rothman KJ, Greenland S. Modern Epidemiology, 2nd edn. Lippincott-Ravan, Philadelphia, 1998.
  3. [14]14. Agresti A. Categorical Date Analysis, 2nd edn. John Wiley & Sons, New York, 2002; 314-356.
  4. [17]17. Moller-Leimkuhler AM. Men and depression: gender- related help-seeking behavior. Fortschr. Neurol. Psychi- atr. 2000; 68: 489-495.
  5. [19]19. Rutz W. The role of primary physicians in preventing sui- cide: possibilities, short comings, and the challenge in male suicide. In: Lester D (ed). Suicide Prevention. Resources for the Millennium. Brunner-Routledge, Phil- adelphia, 2000; 173-187.

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Authors
OYAMA, H., WATANABE, N., ONO, Y., SAKASHITA, T., TAKENOSHITA, Y., TAGUCHI, M., TAKIZAWA, T., MIURA, R., & KUMAGAI, K.
Affiliations
  • Ritsumeikan University (JP)
  • Keio University (JP)
  • St. Marianna University School of Medicine (JP)
  • Hachinohe Gakuin Junior College (JP)
Corresponding author
OYAMA, HIROFUMI
ORCID
Venue
Psychiatry and Clinical Neurosciences
Publisher
Wiley
Published
2005-05-16
Volume
59
Issue
3
Pages
337-344
ISSN
  • 1323-1316 (ISSN-L)
  • 1440-1819
DOI
10.1111/j.1440-1819.2005.01379.x
OpenAlex
W2153322844
Cited by
107
References
16
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 6 · 2016: 8 · 2015: 4 · 2014: 8 · 2013: 6 · 2012: 9
FWCI
5.76
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Psychiatry and Clinical Neurosciences (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
suicide prevention, older adults, older women, group activities, social support, interpersonal relationships, community-based intervention, psychoeducation, rural Japan, suicide rates, sex differences
MeSH terms
Suicide Prevention, Age Factors, Aged, Community Health Services, Depression, Female, Humans, Japan, Sex Factors, Suicide, Program Evaluation, Risk Assessment

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