Characteristics of Suicide Prevention Programs Implemented for Young People in Rural Areas: A Systematic Review of the Literature

BackgroundFor young living in rural areas around the world, suicide is a leading cause of death, stressing the need to understand characteristics of programs aiming to impact suicide and related behaviours.AimA systematic literature review aimed to synthesise the evidence and explore characteristics of programs seeking to impact suicidal behaviours (rates, attempts, ideation) for young people in rural areas.MethodData sources: Electronic databases EMBASE, Medline, PsycINFO and Scopus. Study eligibility criteria, participants, and interventions: Studies measuring suicide-related outcomes (rates, attempts, ideation) for youth (people aged 12-25 years) in rural areas worldwide, published 1 January 2000 to 6 June 2023. Study appraisal and synthesis: Data were thematically analysed, exploring intervention characteristics. Mixed Methods Appraisal Tool assessed study quality.ResultsEleven (11) studies met the selection criteria. Studies impacting suicides and attempts were often multiple strategies, multi-layered, combining universal, selective, and indicated programs, implemented across systems and settings, including public-health psychoeducation, referral mechanisms, crisis lines, postvention, peer support, outreach, means restriction, mindfulness, and gatekeeper training. Psychoeducation and mindfulness contributed to decreased suicidal ideation. Community-level partners were central to efforts, including working groups, networks, Indigenous people, people with lived experience, volunteers, and peers.ConclusionsVaried programs have capacity to reduce suicide rates and related behaviours among young people in rural areas, with communities and schools as crucial settings. Programs implemented across levels show promise at reducing the number of young people who end their lives by suicide or attempt to do so, demonstrating a need for program evaluations and continued, long-term outcome monitoring.