Suicide prevention psychosocial interventions for youth in low- and middle-income countries: systematic review.

BACKGROUND

Suicide is a significant global public health problem, with a disproportionately large burden among youth in low- and middle-income countries (LMICs). Despite growing awareness of the problem, evidence-based interventions in these settings are scarce.

AIMS: This systematic review aims to identify and synthesise the evidence-based literature on the effectiveness of psychosocial-interventions to prevent suicide among young people aged 10-24 years in LMICs to reduce the risk of suicide and improve their mental-wellbeing.

METHOD: After registering protocol with the PROSPERO database of systematic reviews (CRD 420251016364), we searched electronic databases (e.g., PubMed, Medline, Cochrane Library, APA PsycINFO, Scopus, EMBASE, Web of Science and Google Scholar) for potential studies. We considered relevant literature in the English language and published from January 2000 to March 2025. Studies eligible for inclusion were psychosocial interventions compared with a control group, conducted on adolescents in LMICs, and with suicidal-ideation and suicide attempt as primary outcome. Reducing symptoms of anxiety and depression as well as improvements in quality of life were considered as secondary outcomes.

RESULTS

Among 1,223 identified studies, only four met the inclusion criteria. Despite the limited evidence base, all included trials reported reductions in suicidal ideation and improvements in emotional well-being, suggesting the potential effectiveness of culturally adapted psychosocial approaches. Estimated intervention effect sizes ranged from large to extremely large (Cohen's d = 1.46, 2.08, 1.30 and 3.02, respectively), compared with small-to-moderate effect sizes from high-income countries (d ≈ 0.24 to 0.54). Secondary benefits were noted for hopelessness, depressive symptoms and quality of life. However, interpretation is limited by small samples and inconsistent methods, reducing comparability with high-income data.

CONCLUSIONS

The review highlights major gaps in youth suicide prevention within LMICs, emphasising the urgent need for contextually relevant, evidence-based psychosocial interventions and policy frameworks. Findings suggest moderate effectiveness of current interventions, underscoring the importance of culturally tailored implementation to enhance impact.