Effectiveness of suicide prevention programs for emergency and protective services employees: A systematic review and meta-analysis

Background: This brief report summarizes the international literature on the effectiveness of suicide prevention programs for protective and emergency services employees. Methods: A systematic search of 11 electronic databases was undertaken until June 30, 2015. Quantitative meta-analysis was undertaken to investigate the effectiveness of these programs on suicide rates at post-intervention. Qualitative analyses were also used to identify program components that may be associated with reductions in suicide rates. Results: A total of 13 studies were included. Only six reported sufficient information on suicide rates to enable inclusion in quantitative analyses, however. On average, these programs were associated with an approximate halving in suicide rates over an average follow-up period of 5.25 years (SD=4.2; range: 1-11) (Incidence Rate Ratio 0.45, 95%CI 0.31-0.65; five studies; I² 14.8%). Few programs integrated activities at the primary prevention level. Conclusion: A greater focus on the relatively neglected area of workplace primary prevention could further improve suicide prevention effectiveness.