A systematic review with meta-analysis of psychosocial suicide prevention interventions among U.S. military service members and veterans
In brief
Psychosocial programs cut suicide-attempt risk 32% in US veterans and service members
A meta-analysis of 41 controlled trials found psychosocial interventions reduced suicide-attempt risk by 32% and self-harm by 21% compared with control conditions. They did not reduce suicidal thoughts, and the evidence could not establish an effect on suicide deaths, leaving their impact on those outcomes unresolved.
- Journal
- Journal of affective disorders (Q1)
- Published
- 3 November 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Nicole K Ciesinski, Eliana J Trikeriotis, Emily K Grim, Corinne N Kacmarek, Peter L Phalen, Elizabeth A Klingaman, et al.
- PMID
- 42976993
- DOI
- 10.1016/j.jad.2026.122687
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 7 November 2026): Meta-analysis of psychosocial suicide prevention interventions
Abstract
Suicide rates among U.S. military service members and veterans are disproportionately high relative to civilians and increasing over time. Veterans and service members experience unique suicide risk factors, highlighting the need for suicide prevention approaches optimized for this community. A vast number of psychosocial suicide prevention treatments produce variable effects (ranging from small to moderate) on suicidal thoughts and behaviors in the general population, and findings often do not concur with studies conducted in military and veteran samples. The present study systematically reviewed 47 and meta-analyzed 41 controlled trial studies (N = 5,540,004) published in EBSCO, PubMed, Cochrane Central Register of Controlled Trials and other sources between 1996 and 2026 assessing the efficacy of psychosocial suicide prevention interventions among U.S. military veterans and service members. Risk of bias and several participant, intervention, and study design characteristics were assessed for potential moderating effects. Suicide prevention interventions significantly outperformed control conditions in reducing risk of suicide attempts (RR = 0.68, 95% CI [0.56, 0.83], p < .001) and self-harm (RR = 0.79, 95% CI [0.67, 0.93], p = .004), but not suicidal ideation (ps > 0.50). Meta-analysis for suicide death outcomes was inconclusive due to sample limitations. Few participant, intervention, or study design moderators of treatment efficacy emerged, contrary to hypotheses (e.g., no effect of CBT, clinical severity). Findings suggest that psychosocial suicide prevention interventions demonstrate efficacy in reducing risk of suicidal behaviors but do not establish efficacy in reducing suicidal ideation or suicide death risk in the U.S. military and veteran community.
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.