Comparative Effects of Psychosocial and Behavioral Interventions to Prevent or Reduce Suicidal Ideation and Suicidal Behavior: A Network Meta-Analysis
In brief
Psychotherapy lowers odds of suicidal behavior by 40% across prevention trials
Across 94 randomized trials involving 27,242 adolescents and adults, psychotherapy was linked to 40% lower odds of suicidal behavior than control and also reduced suicidal thoughts and self-harm. Active outreach and other psychosocial approaches also reduced suicidal behavior, but psychotherapy was the only intervention that improved self-harm; the evidence was moderate quality, and effects may vary across settings.
- Journal
- The International journal of social psychiatry (Q1)
- Published
- 17 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Tra-My Ngoc Nguyen, Kim-Ngan Thi Ta, Kai-Jen Chuang
- PMID
- 42892731
- DOI
- 10.1177/00207640261496219
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 19 October 2026): Comparative effects of psychosocial interventions on suicide outcomes
Abstract
BACKGROUND: Previous meta-analyses combined treatment with prevention interventions and there was a lack of comparative studies on preventive interventions for suicide. AIMS: To evaluate and rank the effects of prevention interventions on self-harm, suicidal ideation, suicidal behavior, and depression. METHODS: We searched PubMed, HINARI, CENTRAL and ResearchGate until November 2025 to identify randomized controlled trials that reported suicidal ideation and suicidal behavior among adolescents and adults. Eligible studies were selected through systematic screening, and data were synthesized using a network meta-analysis with a random-effects model to assess and rank effects of psychosocial and behavioral interventions in January 2026. RESULTS: This study included 94 trials (27,242 participants). Compared with control group, psychotherapy (Odds ratio [OR] = 0.60; 95% CI [0.47, 0.76]), active outreach (OR = 0.73; 95% CI [0.59, 0.90]), and other psychosocial and behavioral interventions (hereafter, "other type"; OR = 0.53; 95% CI [0.33, 0.86]) were the three most effective interventions in preventing suicidal behavior (moderate-quality evidence). Psychotherapy (Standardized mean difference [SMD] = -0.18; 95% CI [-0.31, -0.05]; moderate-quality evidence) and other type (SMD = -0.60; 95% CI [-0.86, -0.33]; moderate-quality evidence) were the two most effective interventions in preventing suicidal ideation. Only psychotherapy was significantly more effective than control group (OR = 0.66; 95% CI [0.48, 0.91]; moderate-quality evidence) in reducing self-harm. Only skills showed effectiveness in reducing depression with very low-quality evidence (SMD = -0.67; 95% CI: [-1.07, -0.28]). CONCLUSIONS: Psychotherapy consistently improved several suicide-related outcomes, indicating that clinical and community settings should prioritize this intervention. Healthcare policymakers and practitioners should integrate psychotherapy into regular mental health services and expand active outreach activities to improve conditions and use of the beneficiaries.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.