Interventions for Adolescent Suicidality in Latin America: A Systematic Review

Background and Purpose: Suicide is a serious public health concern that is on the rise in Latin American countries. However, limited progress has been made on the development of suicide prevention programs for Latino youth. A systematic review was conducted to examine the effectiveness of interventions designed to reduce and prevent suicidality among adolescents in Latin American countries.

Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Metanalyses (PRISMA). Studies appearing in peer-reviewed journals indexed in PsychInfo, PubMed, LILACS, Social Work Abstracts and ProQuest databases were searched from 2008 to 2021. Risk of bias was assessed using ROBINS-I tool recommended by Cochrane Reviews for non-randomized studies of interventions

Results: In total, 2136 abstracts were identified, 1041 were screened for inclusion, after removing duplicates. Of these, seven studies fulfilled all the inclusion criteria. The studies were conducted in Colombia, Brazil, Puerto Rico, Cuba, Perú and Mexico. In terms of the risk of bias, five studies were classified at critical risk of bias, one at serious risk of bias, and one as moderate. Results show that one study had a large effect on reducing suicidal ideation (Cohen’s d = -1.09, p <.001), two had large effects on reducing suicidal risk (Cohen’s d = - 0.89, p < .001; d = - 0.63, p <.001) and one had a large effect when the outcome was knowledge of suicidal behaviors (Cohen’s d = 1.27, p < .001). When considering its large effect size in reducing suicide ideation and having a moderate risk of bias, the most promising intervention was the Educational intervention for the prevention of suicidal behavior in adolescents (Cañón et al., 2018). The intervention is an 8-session group-based protocol that aimed at enhancing protective factors to prevent suicide, increase assertiveness and teach problem solving skills.

Conclusions and Implications: There are promising interventions to reduce suicidality in Latin America. That said, there is limited research regarding suicidality in Latin America and much of it needs strengthening in rigor. The seven studies tested interventions that were designed by the authors or their research groups, were not replicated, and the research generally had elevated risks of bias. These results highlight the importance of conducting further trials in Latin American countries to effectively treat youth suicidality.