Cited by 655Suicide and Self-Harm StudiesGun Ownership and Violence ResearchHomicide, Infanticide, and Child Abuse

The DOI matches its Crossref record; 155 of the 155 references it cites were found in a registry or an index; 92 of the 219 sources its claims cite were checked for support.

Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review

Open access
Mann, J. John, Michel, Christina A., Auerbach, Randy P.·2021·American Journal of Psychiatry

Abstract

OBJECTIVE: The authors sought to identify scalable evidence-based suicide prevention strategies. METHODS: A search of PubMed and Google Scholar identified 20,234 articles published between September 2005 and December 2019, of which 97 were randomized controlled trials with suicidal behavior or ideation as primary outcomes or epidemiological studies of limiting access to lethal means, using educational approaches, and the impact of antidepressant treatment. RESULTS: Training primary care physicians in depression recognition and treatment prevents suicide. Educating youths on depression and suicidal behavior, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevents suicidal behavior. Meta-analyses find that antidepressants prevent suicide attempts, but individual randomized controlled trials appear to be underpowered. Ketamine reduces suicidal ideation in hours but is untested for suicidal behavior prevention. Cognitive-behavioral therapy and dialectical behavior therapy prevent suicidal behavior. Active screening for suicidal ideation or behavior is not proven to be better than just screening for depression. Education of gatekeepers about youth suicidal behavior lacks effectiveness. No randomized trials have been reported for gatekeeper training for prevention of adult suicidal behavior. Algorithm-driven electronic health record screening, Internet-based screening, and smartphone passive monitoring to identify high-risk patients are understudied. Means restriction, including of firearms, prevents suicide but is sporadically employed in the United States, even though firearms are used in half of all U.S. suicides. CONCLUSIONS: Training general practitioners warrants wider implementation and testing in other nonpsychiatrist physician settings. Active follow-up of patients after discharge or a suicide-related crisis should be routine, and restricting firearm access by at-risk individuals warrants wider use. Combination approaches in health care systems show promise in reducing suicide in several countries, but evaluating the benefit attributable to each component is essential. Further suicide rate reduction requires evaluating newer approaches, such as electronic health record-derived algorithms, Internet-based screening methods, ketamine's potential benefit for preventing attempts, and passive monitoring of acute suicide risk change.

Overview

Integrity signals

Registry

Crossref · 10.1176/appi.ajp.2020.20060864

Cites

155 of 155 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

35 Partly supported · 34 No full text of the sources · 21 No basis given · 9 Sources not found · 9 Own interpretation · 8 Own method · 6 Own result · 5 Mixed support · 5 Not checked yet · 3 Supported so far · 2 Supported · 2 Couldn’t confirm · 1 Not supported · accuracy not yet measured

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Show all 94 claims

  • It may state two separate claims as one. 42
  • Probably not a substantial claim. 7
46 of 46
  • The paper relies on this without support.

    Firearms account for half of all suicides in the United States.

    “even though firearms are used in half of all U.S. suicides.”
  • The paper relies on this without support.

    The volume of suicide prevention articles published from 2005 to 2019 was more than four times the volume published from 1966 to 2005.

    “From 2005 to 2019, over four times as many articles on suicide prevention were published compared with the previous 40 years (1966–2005).”
  • The paper relies on this without support.

    Replicated efficacy for preventing suicidal behavior and scalability are appropriate criteria for determining the best suicide prevention options.

    “Applying the criteria of replicated efficacy for preventing suicidal behavior (Table 1) and scalability means that the best options for suicide prevention are:”
  • The paper relies on this without support.

    Suicidal ideation as an outcome measure is not as closely related to suicide as nonfatal suicide attempts.

    “Suicidal ideation as an outcome measure is not as closely related to suicide as are nonfatal suicide attempts.”
  • The paper relies on this without support.

    Legal precedents and public opinion have undermined gun control and buyback programs in the United States.

    “but legal precedents and public opinion have undermined gun control and buyback programs, so the U.S. has not been able to emulate implementation of such programs”
5 of 5

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Citations

Cites

Show all 155 references

Research works printed but not linked: 7

  1. Xu J, 2016, NCHS Data Brief, 267, 1
  2. Curtin SC, 2016, NCHS Data Brief, 241, 1
  3. Takahashi K, 1998, Seishin Shinkeigaku Zasshi, 100, 469
  4. Dube P, 2010, Prim Care Companion J Clin Psychiatry, 12
  5. Ebrahimi H, 2014, J Caring Sci, 3, 131
  6. Hazell PL, 2009, J Am Acad Child Adolesc Psychiatry, 48, 662
  7. Kreitman N, 1976, Br J Prev Soc Med, 30, 86

Cited by

Sorted by citations

Items 401–500 of 558

Metadata

Authors
Mann, J. J., Michel, C. A., & Auerbach, R. P.
Affiliations
New York State Psychiatric Institute (US)
Venue
American Journal of Psychiatry
Published
2021-07
Volume
178
Issue
7
Pages
611-624
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
OpenAlex
W3131404594
Cited by
655
References
155
Citations by year
2026: 130 · 2025: 166 · 2024: 155 · 2023: 105 · 2022: 71 · 2021: 26
FWCI
10.22
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (P50MH090964, U01MH116923, U01MH108168)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Health › Gun Ownership and Violence Research
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
suicide prevention, suicidal ideation, suicidal behavior, primary care physicians, youth suicide, gatekeeper training, antidepressants, ketamine, cognitive behavioral therapy, dialectical behavior therapy, suicide risk screening, electronic health record algorithm, internet-based screening, firearm access restrictions, means restriction
MeSH terms
Suicide Prevention, Humans, Mass Screening, Evidence-Based Practice

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