Disaster and suicide prevention activities: A literature review focused on suicide-related outcomes

BACKGROUND: Numerous epidemiological studies regarding suicide after disasters exist, but there are few comprehensive reviews pertaining to suicide prevention activities after disasters. Therefore, this review aimed to consider the kinds of suicide prevention activities that have been implemented and which may be effective. METHODS: A search was carried out to find articles that mentioned the implementation of suicide prevention activities after natural, human-made, and infectious disasters. RESULTS: Twenty-nine articles were reviewed from 492 identified articles and were categorized into the following: suicide prevention interventions in community and school settings, telephone and online interventions, and suicide prevention guidelines. One-third of the reviewed articles included the outcomes of the activities, revealing no steep increase in suicides in the affected area and a decreased rate of suicidal ideation during interventions. Some of activities were 1) targeted vulnerable individuals like those who were strongly affected by the disaster, the elderly, and the needy, and 2) continued as interventions over a long-term period while building a more sustainable and intensive community mental health system, which is considered a difference from non-disaster times. Limitations: There is a risk of selection bias. There were less than half of the research articles examined suicide prevention interventions with outcomes, and these articles did not have a high evidence level. CONCLUSION: Although only a limited number of articles have examined suicide prevention activities with outcomes, the key point may be the continuation of interventions in the long term for vulnerable individuals and the strengthening and rebuilding of the community mental health system for suicide prevention. Moreover, it is necessary to identify the best ways to engage to contact vulnerable individuals in post-disaster settings.