Suicide among the elderly: The long-term impact of a telephone support and assessment intervention in northern Italy

TLDR

Earlier studies showed that elderly users of the Tele Help–Tele Check telephone helpline experienced fewer suicides. The study aimed to assess the long‑term impact of the Tele Help–Tele Check service on suicide rates among elderly people in northern Italy and to investigate why the benefit may be absent in men. The intervention consisted of twice‑weekly support and needs‑assessment calls plus a 24‑hour emergency alarm, and the study compared 18,641 service users from 1988‑1998 with a matched general population cohort in Veneto. Over a decade, users had a 71.2 % reduction in suicide mortality (SMR 28.8 %) compared with expectations, with a pronounced effect in women (SMR 16.6 %), confirming the service’s long‑term effectiveness.

Abstract

Background Previous short-term work reported fewer suicides among elderly users of a telephone helpline and emergency response service (the Tele Help–Tele Check Service). Aims To examine long-term effects of the service on suicide in an elderly population of northern Italy. Method The service provided twice-weekly support and needs assessment telephone calls and a 24 h emergency alarm service. Data from 1988 to 1998 allowed comparison of 18 641 service users with a comparable general population group of the Veneto region in Italy. Results Significantly fewer suicide deaths ( n OBSERVED =6) occurred among elderly service users (standardised mortality ratio (SMR) 28.8%) than expected ( n EXPECTED =20.86; χ 2 =10.58, d.f.=1, P < 0.001) despite an assumed overrepresentation of persons at increased risk. The service performed well for elderly females ( n OBSERVED =2, SMR=16.6%, n EXPECTED =12.03; χ 2 =8.36, d.f.=1, P < 0.001). Conclusions The study confirms the initial promise of the Tele Help–Tele Check service over a much longer time period. Further research will clarify the apparent lack of benefit for elderly males.