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J Geriatr Psychiatry Neurol. 2019 Dec 16:891988719892343. doi: 10.1177/0891988719892343. [Epub ahead of print]

Suicide Prevention Interventions for Older People in Nursing Homes and Long-Term Care Facilities: A Systematic Review.

Author information

Suicide Prevention Centre, le Vinatier hospital, Bron, France.
EA 7425 HESPER Health Services and Performance Research, Claude Bernard Lyon 1 University, Lyon, France.
Institut de Recherches Philosophiques de Lyon, Jean Moulin Lyon 3 University, Lyon, France.
UMR INSERM 1027, Toulouse University, Toulouse, France.
University Hospital, Toulouse, France.
Psychiatrie des Urgences, Edouard Herriot university hospital, Lyon, France.
PsyR2 team, Centre de Recherche en Neurosciences de Lyon, INSERM U1028 / CNRS UMR 5292 / Claude Bernard Lyon 1 University, le Vinatier hospital, Bron, France.
Pôle Information Médicale Evaluation Recherche, Edouard Herriot university hospital, Lyon, France.



The death rate due to suicide among older people is high, especially among men. Because many older people live in nursing homes or long-term care facilities in high-income countries, reviewing the impact of prevention strategies on the suicidal behavior of residents in these settings is of interest.


Following PRISMA guidelines, we performed a systematic review of the existing literature found in Pubmed, Scopus, Web of Science, PsycINFO, and Sociological Abstracts, focusing on interventions to prevent suicidal behavior or ideation in nursing home residents. The studies' quality was evaluated according to TIDieR and MMAT.


Only 6 studies met the inclusion criteria. Four of them described various "gatekeeper" trainings for nursing home staff and 2 described interventions focused on residents. Only 1 study was randomized. Gatekeeper training studies were mostly before/after comparisons. No intervention demonstrated a direct effect on suicidal ideation or behaviors. One study showed that "life review" had a long-lasting effect on depression scores and another that gatekeeper training led to changes in the care of suicidal residents.


Interventions to prevent suicidal ideation or behaviors in nursing homes are not rigorously evaluated, and no conclusion can be drawn on their effectiveness in preventing suicidal behaviors. We propose to better evaluate gatekeeper training for staff as well as peer support. Individual interventions targeting residents could be modified for broader implementation.


geriatric psychiatry; long-term care; nursing home; older people; suicide prevention


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