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Open Access Highly Accessed Research article

Interventions to reduce suicides at suicide hotspots: a systematic review

Georgina R Cox1, Christabel Owens2, Jo Robinson1, Angela Nicholas3, Anne Lockley3, Michelle Williamson3, Yee Tak Derek Cheung3 and Jane Pirkis3*

Author Affiliations

1 Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia

2 University of Exeter Medical School, Exeter, UK

3 Centre for Health Policy, Programs and Economics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

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BMC Public Health 2013, 13:214  doi:10.1186/1471-2458-13-214

Published: 9 March 2013

Abstract

Background

‘Suicide hotspots’ include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention.

Methods

We searched Medline for studies that could inform the following question: ‘What interventions are available to reduce suicides at hotspots, and are they effective?’

Results

There are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise.

Conclusions

More well-designed intervention studies are needed to strengthen this evidence base.

Keywords:
Suicide hotspots; Suicide prevention; Intervention