A Systematic Review of Suicide Prevention Interventions in Military Personnel

Abstract

Objective

In response to the increasing rates of suicide in military personnel throughout the world, there is an increasing focus on the development and implement of interventions aimed at preventing suicide among this group. Therefore, the goal of the present systematic review was to examine the effectiveness of interventions focused on preventing suicidal ideation and behavior in military personnel.

Method

Search for articles was conducted in PsycINFO, PubMed, Web of Science, EMBASE, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), IranMedex, Scientific Information Database (SID), and MagIran. International databases were searched from June 2008 to May 2019, and Iranian databases were searched from their inception to May 2019. RCT and non-RCT studies focused on the effectiveness of preventive interventions for suicide in military personnel were included in the analysis. Narrative synthesis of results was the main strategy for data analysis.

Results

According to the inclusion and exclusion criteria, 18 articles were selected. Interventions were divided into four categories according to their nature: interventions based on psychotherapy, interventions based on crisis management, interventions based on pharmacotherapy, and community-based interventions. In addition, most studies had moderate methodological quality.

Conclusion

Most of the preventive interventions were effective in reducing suicidal ideation and behavior in military personnel; however, in some cases, there were serious challenges in terms of effectiveness. Interventions based on cognitive-behavioral approaches constitute a significant portion of the interventions. Overall, RCTs and non-RCTs, especially community-based studies, need to use more rigorous examinations in order to gain research and clinical support.

HIGHLIGHTS

• Interventions based on psychotherapy and community-based interventions were the most commonly used interventions, respectively.

• The majority of interventions based on psychotherapy came from cognitive-behavioral approaches.

• There are few evidence-based studies on prevention of suicide in military personnel.

Keywords:

• Military personnel
• prevention
• soldiers
• suicide
• systematic review

ACKNOWLEDGMENTS

Thanks to Mahshid Foroughan and Seyed Jalal Younesi, for their assistance and guidance in conducting this study. This research received no specific grant from any funding agency.

DISCLOSURE STATEMENT

The authors declare that there is no conflict of interests.

AUTHOR NOTES

Mohammad Rostami and Fatemeh Rahmati-Najarkolaei, Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mahmood Salesi, Chemical Injuries Research Center, Systems biology and poisonings institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Esfandiar Azad, Behavioral sciences research center, life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.