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Cited by 186Suicide and Self-Harm StudiesIndigenous Health, Education, and RightsHomicide, Infanticide, and Child Abuse

A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

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Clifford, Anton C, Doran, Christopher M, Tsey, Komla·2013·BMC Public Health
DOI 10.1186/1471-2458-13-463PMC PMC3663804
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Abstract

BACKGROUND: Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. METHODS: A systematic search of 17 electronic databases and 13 websites for the period 1981-2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. RESULTS: Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. CONCLUSIONS: There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous populations. Combining and tailoring best evidence and culturally-specific individual strategies into one coherent suicide prevention program for delivery to whole Indigenous communities and/or population groups at high risk of suicide offers considerable promise.

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  • Acceptance and commitment therapy has been found efficacious in depression, anxiety and stress.

    “Acceptance and commitment therapy has been found to be efficacious in a number of mental health domains, including depression [10], anxiety [11] and stress [12].”

    From The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial. (2013) · cites this paper as [11]

    The Results sections on effectiveness and data collection (page not provided) discuss Indigenous suicide-prevention interventions and mention depression as a measured risk factor, but do not identify acceptance and commitment therapy or assess its efficacy. Searches for “acceptance and commitment therapy stress” and “ACT depression anxiety stress efficacy” found no passage addressing the cited claim, particularly its stress component. (LLM, conf=0.76)

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Authors
Clifford, A. C., Doran, C. M., & Tsey, K.
Affiliations
  • Institute for Urban Indigenous Health (AU)
  • Hunter Medical Research Institute (AU)
  • James Cook University (AU)
Corresponding author
Clifford, Anton C
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2013-05-13
Volume
13
Issue
1
Pages
463-463
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-13-463
PMC
PMC3663804
OpenAlex
W2076166069
Cited by
186
References
52
Citations by year
2026: 5 · 2025: 11 · 2024: 13 · 2023: 12 · 2022: 12 · 2021: 22 · 2020: 18 · 2019: 11 · 2018: 16 · 2017: 16 · 2016: 23 · 2015: 14 · 2014: 11 · 2013: 2
FWCI
2.46
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ResearchOnline - JCU (James Cook University) (submittedVersion)
  • Acquire (CQUniversity) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • NOVA (University of Newcastle Australia) (submittedVersion)
Funders
NSW Ministry of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Health › Indigenous Health, Education, and Rights
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
suicide prevention, indigenous peoples, Indigenous suicide, gatekeeper training, community-based prevention, suicide education, Aboriginal Australians, Native Americans, First Nations, culturally tailored interventions, suicidal behavior
MeSH terms
Indigenous Peoples, Suicide Prevention, Adolescent, Adult, Australia, Canada, Child, Female, Health Education, Humans, Indians, North American, Male, Middle Aged, New Zealand, Preventive Health Services, Suicide, United States, Population Groups, Native Hawaiian or Other Pacific Islander, Young Adult

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