Suicide
Conditions
Keywords
suicide, prevention
Brief summary
The purpose of this study is to examine the effectiveness of a community-based depression-screening program for suicide prevention among middle-aged adults, the investigators conducted a quasi-experimental intervention study, using a parallel cluster design with communities at municipal level as the unit of allocation and individuals as the unit of analysis.
Detailed description
Suicide is a major cause of premature death, particularly among middle-aged adults, in the majority of Western and Asian countries. A strong association of suicide and depression often indicates the necessity of a high-risk approach for suicide prevention. Improvements in identification and treatment can lead to better depression outcomes and suicide prevention. The investigators hypothesize that a 4-year community-based intervention, consisting of universal depression screening and subsequent care support in the target areas and health education programs, would result in reduced suicide rates among the middle-aged adult population in areas with a high suicide rate.
Interventions
BEHAVIORALSuicide prevention program as usual
Usual mental health program (not including depression screening among middle-aged)
BEHAVIORALMulti-level suicide prevention programs
The intervention included both screening and educational components. The screening component invited residents aged 36-64 years to participate in a two-step screening program. In the initial screening, a self-report questionnaire were mailed to all of those residents in the priority districts with a past high suicide rate. The second stage was conducted for the participants who screened positive though a semi-structural interview. Based on the results, participants who were diagnosed with a major depressive episode were provided with a referral to a psychiatry and support for treatment adherence. Written feedback on the screening results was mailed to all respondents. The educational component was implemented through workshops open to the general public (3 times every year) and local public newsletters (twice every year) designed to improve access and adherence to treatment and to reduce stigma associated with suicide and depression.
Sponsors
Aomori University of Health and Welfare
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
36 Years to 64 Years
Healthy volunteers
No
Inclusion criteria
* A municipal area located in the following 4 Aomori Second Medical Zones: Hachinohe, Kamitosan, Aomori, and Tsugaru. * A municipal area with the higher suicide rate than the prefectural average. * A municipal area having the sufficient and coverable size to serve the intervention (population 10,000-99,999).
Exclusion criteria
* A municipal area receiving further intervention including a depression screening for middle-aged adults.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in suicide rates among adults aged 40-64 years between the 4-year pre- and implementation periods. | 4 years pre versus 4 years post |
Secondary
| Measure | Time frame |
|---|---|
| Invitation rate in the screening component | 4 years post |
| Participation rate in the screening component | 4 years post |
Countries
Japan
Outcome results
None listed