Effectiveness and gender-tailoring of suicide prevention interventions for men: a systematic review.

چکیده اصلی

BACKGROUND: Men have 2-4 times higher suicide mortality than women and are less likely to seek help, with disparities linked to restrictive masculine norms and stigma. This review aimed to synthesize the effectiveness of suicide prevention interventions targeting men and identify gender-tailoring strategies. METHODS: Studies evaluating suicide prevention interventions targeting men were included if conducted in male-only samples and reporting outcomes related to suicidality (e.g., suicide deaths, suicide attempts, suicidal ideation), depression, or help-seeking (e.g., behaviors, intentions, attitudes). Six databases (MEDLINE, Embase, PsycINFO, Cochrane Library, Web of Science, and CINAHL) were searched for peer-reviewed English-language studies published up to 31 December 2025. Risk of bias was assessed using RoB 2 and ROBINS-I. Due to heterogeneity, findings were synthesized narratively. The protocol was registered in PROSPERO (CRD420250655554). RESULTS: Seventeen articles evaluating 14 interventions were included. Only one study assessed suicide deaths, and none occurred. Among RCTs, no significant effects were observed for suicide attempts, suicidal ideation, or depression. Help-seeking behaviors and intentions showed mixed evidence of improvement, with no improvement in help-seeking attitudes. Gender-tailoring strategies were synthesized into seven categories: intervention design and development, risk targeting, content and messaging, outreach and recruitment, delivery modalities, male representation and role modeling, and communication and action orientation. CONCLUSIONS: Evidence for the effectiveness of suicide prevention interventions targeting men remains limited, with no clear effects on suicidality or depression and mixed evidence for improvements in help-seeking. Risk of bias was generally moderate to high. A wide range of gender-tailoring strategies was identified. Further development of gender-responsive approaches and more rigorous evaluation are needed to reduce male suicide mortality.

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