ABSTRACT
Introduction
Suicide rates remain elevated for current and ex-serving military populations, yet the effectiveness of suicide interventions for these populations is unclear. Therefore, a synthesis and analysis of interventions is needed. This systematic review and meta-analysis aims to identify which interventions may be effective for suicidal ideation and behaviors among current and ex-serving military personnel.
Method
This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Datasets were drawn from the Suicide Prevention Trials Database. Meta-analyses of randomized controlled trials were conducted using standardized mean change for suicidal ideation and pooled log odds ratio for suicidal behaviors.
Results
In total, 24 studies were eligible. Most studies were randomized controlled trials (n = 17) from the United States (n = 21) and comprised indicated interventions (n = 17). Meta-analyses found no significant pooled effects for suicidal ideation and behaviors. Moderation analyses found that care management, follow-up, or monitoring; and nonpharmacological biological interventions were more effective than behavioral interventions for suicide attempts. Selective, multicomponent interventions demonstrated encouraging outcomes.
Conclusion
The review found no evidence of overall effects for the current interventions on suicidal ideation and behaviors. Future interventions should be based on suicide theories and co-developed with individuals with military and suicidality lived experience.