Community‐based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females

Abstract

The lack of social support is the most common risk factor for late‐life suicide. Few previous community‐based interventions against the lack of social relationships reduced suicide. This study aims to evaluate outcomes of a community‐based prevention program against suicide amongst the elderly in rural Japan. During 1995–2002, the program based on population strategy including group activity, psychoeducation and self‐assessment of depression but no screening for depression, was implemented for elderly residents in Yuri town, Japan (5‐year average population 6817; 5‐year average suicide rate [≥65 years old] 291.4/10⁵). Changes in the relative risk of suicide for individuals (≥65 years old) before and after the 8‐year implementation were estimated by the incidence rate ratio (IRR), using a quasi‐experimental design with a neighboring reference, Chokai town, Japan (5‐year average population 8136; 5‐year average suicide rate [≥65 years old] 216.5/10⁵). The risk of elderly females in Yuri completing suicide was reduced by 76% (age‐adjusted IRR, 0.24; 95% CI, 0.10–0.58), while there was no change in the risks for Yuri's elderly males and both Chokai's elderly males and females. General loglinear analysis estimated a ratio of the female IRR in Yuri to that in its Akita prefecture of 0.35 (95% CI, 0.14–0.84), showing that the reduction of the risk in the intervention area was greater than a historical trend. A community‐based suicide prevention through a group intervention designed to increase knowledge and to cultivate social relationships would be effective for elderly females but not males.