Effectiveness of suicide means restriction: an overview of systematic reviews

Steeg, Sarah; Ledden, Sarah; Marzano, Lisa; Dutta, Rina; Quinlivan, Leah; Kapur, Nav; John, Ann; Webb, Roger Thomas

doi:10.1136/bmjment-2025-302069

Journal article 39 views 13 downloads

Effectiveness of suicide means restriction: an overview of systematic reviews

Sarah Steeg

, Sarah Ledden, Lisa Marzano

, Rina Dutta, Leah Quinlivan, Nav Kapur

, Ann John

, Roger Thomas Webb

BMJ Mental Health, Volume: 28, Issue: 1, Start page: e302069

Swansea University Author: Ann John

PDF | Version of Record

© Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license.
Download (1.27MB)

Check full text

DOI (Published version): 10.1136/bmjment-2025-302069

Abstract

Question Means restriction for suicide prevention at a population level typically involves policy or environmental changes to limit access to suicide methods. Several systematic reviews of suicide means restriction exist. This umbrella review aimed to synthesise their findings, assess evidence quali...

Full description

Published in:	BMJ Mental Health
ISSN:	2755-9734
Published:	BMJ 2025
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa70920

first_indexed	2025-11-17T16:02:13Z
last_indexed	2026-01-08T05:21:33Z
id	cronfa70920
recordtype	SURis
fullrecord	<?xml version="1.0"?><rfc1807><datestamp>2026-01-07T14:42:29.0775961</datestamp><bib-version>v2</bib-version><id>70920</id><entry>2025-11-17</entry><title>Effectiveness of suicide means restriction: an overview of systematic reviews</title><swanseaauthors><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-11-17</date><deptcode>MEDS</deptcode><abstract>Question Means restriction for suicide prevention at a population level typically involves policy or environmental changes to limit access to suicide methods. Several systematic reviews of suicide means restriction exist. This umbrella review aimed to synthesise their findings, assess evidence quality, quantify primary study overlap and identify evidence gaps.Study selection and analysis Searches were conducted across Web of Science, Ovid (PsycINFO, EMBASE), Cochrane and PubMed, supplemented by reference list screening. Study quality was assessed using A MeaSurement Tool to Assess systematic Reviews-2. Study overlap was calculated using the corrected covered area.Findings We included 20 systematic reviews, synthesising evidence from 179 unique primary studies. Physical barriers to prevent jumping showed strong effect sizes, although primary study overlap was high. Train platform screen doors were associated with reduced site-specific suicide mortality, with no evidence of displacement to other sites, although the number of studies was small. Paracetamol pack size limitation reduced self-poisoning admissions, with mixed impacts on mortality. Bans on highly hazardous pesticides reduced suicide rates. More recent reviews suggest firearms restrictions may reduce suicides, but with small effect sizes and methodological limitations. Evidence quality ranged from high to critically low (12/20 rated as critically low). With the exception of pesticide restrictions, lower and middle-income settings were not represented.Conclusions Several means restriction approaches demonstrate effectiveness, although high study overlap and variable study quality were evident. A focus on differential impacts across sociodemographic groups, more evidence from lower and middle-income countries and evidence for suicide prevention on roads and from residential buildings is needed.</abstract><type>Journal Article</type><journal>BMJ Mental Health</journal><volume>28</volume><journalNumber>1</journalNumber><paginationStart>e302069</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2755-9734</issnElectronic><keywords/><publishedDay>9</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-12-09</publishedDate><doi>10.1136/bmjment-2025-302069</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was supported by UK Research and Innovation funding for the Population Mental Health Consortium (Grant no MR/Y030788/1) which is part of Population Health Improvement UK (PHI-UK), a national research network which works to transform health and reduce inequalities through change at the population level. RW and SS are supported by the National Institute for Health and Social Care Research (NIHR) Manchester Biomedical Research Centre (ref. NIHR203308). RW is also supported by the NIHR Greater Manchester Patient Safety Research Collaboration (ref. NIHR204295). AJ is supported by Health and Care Research Wales (HCRW) National Centre for Suicide Prevention and Self-Harm</funders><projectreference/><lastEdited>2026-01-07T14:42:29.0775961</lastEdited><Created>2025-11-17T10:46:09.1712965</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Sarah</firstname><surname>Steeg</surname><orcid>0000-0002-7935-1414</orcid><order>1</order></author><author><firstname>Sarah</firstname><surname>Ledden</surname><order>2</order></author><author><firstname>Lisa</firstname><surname>Marzano</surname><orcid>0000-0001-9735-3512</orcid><order>3</order></author><author><firstname>Rina</firstname><surname>Dutta</surname><order>4</order></author><author><firstname>Leah</firstname><surname>Quinlivan</surname><order>5</order></author><author><firstname>Nav</firstname><surname>Kapur</surname><orcid>0000-0002-3100-3234</orcid><order>6</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>7</order></author><author><firstname>Roger Thomas</firstname><surname>Webb</surname><orcid>0000-0001-8532-2647</orcid><order>8</order></author></authors><documents><document><filename>70920__35908__f5bb48f013ed4cd9ba31f972e5ba051a.pdf</filename><originalFilename>70920.VoR.pdf</originalFilename><uploaded>2026-01-07T14:39:01.8645848</uploaded><type>Output</type><contentLength>1333696</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling	2026-01-07T14:42:29.0775961 v2 70920 2025-11-17 Effectiveness of suicide means restriction: an overview of systematic reviews ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2025-11-17 MEDS Question Means restriction for suicide prevention at a population level typically involves policy or environmental changes to limit access to suicide methods. Several systematic reviews of suicide means restriction exist. This umbrella review aimed to synthesise their findings, assess evidence quality, quantify primary study overlap and identify evidence gaps.Study selection and analysis Searches were conducted across Web of Science, Ovid (PsycINFO, EMBASE), Cochrane and PubMed, supplemented by reference list screening. Study quality was assessed using A MeaSurement Tool to Assess systematic Reviews-2. Study overlap was calculated using the corrected covered area.Findings We included 20 systematic reviews, synthesising evidence from 179 unique primary studies. Physical barriers to prevent jumping showed strong effect sizes, although primary study overlap was high. Train platform screen doors were associated with reduced site-specific suicide mortality, with no evidence of displacement to other sites, although the number of studies was small. Paracetamol pack size limitation reduced self-poisoning admissions, with mixed impacts on mortality. Bans on highly hazardous pesticides reduced suicide rates. More recent reviews suggest firearms restrictions may reduce suicides, but with small effect sizes and methodological limitations. Evidence quality ranged from high to critically low (12/20 rated as critically low). With the exception of pesticide restrictions, lower and middle-income settings were not represented.Conclusions Several means restriction approaches demonstrate effectiveness, although high study overlap and variable study quality were evident. A focus on differential impacts across sociodemographic groups, more evidence from lower and middle-income countries and evidence for suicide prevention on roads and from residential buildings is needed. Journal Article BMJ Mental Health 28 1 e302069 BMJ 2755-9734 9 12 2025 2025-12-09 10.1136/bmjment-2025-302069 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was supported by UK Research and Innovation funding for the Population Mental Health Consortium (Grant no MR/Y030788/1) which is part of Population Health Improvement UK (PHI-UK), a national research network which works to transform health and reduce inequalities through change at the population level. RW and SS are supported by the National Institute for Health and Social Care Research (NIHR) Manchester Biomedical Research Centre (ref. NIHR203308). RW is also supported by the NIHR Greater Manchester Patient Safety Research Collaboration (ref. NIHR204295). AJ is supported by Health and Care Research Wales (HCRW) National Centre for Suicide Prevention and Self-Harm 2026-01-07T14:42:29.0775961 2025-11-17T10:46:09.1712965 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sarah Steeg 0000-0002-7935-1414 1 Sarah Ledden 2 Lisa Marzano 0000-0001-9735-3512 3 Rina Dutta 4 Leah Quinlivan 5 Nav Kapur 0000-0002-3100-3234 6 Ann John 0000-0002-5657-6995 7 Roger Thomas Webb 0000-0001-8532-2647 8 70920__35908__f5bb48f013ed4cd9ba31f972e5ba051a.pdf 70920.VoR.pdf 2026-01-07T14:39:01.8645848 Output 1333696 application/pdf Version of Record true © Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license. true eng https://creativecommons.org/licenses/by/4.0/
title	Effectiveness of suicide means restriction: an overview of systematic reviews
spellingShingle	Effectiveness of suicide means restriction: an overview of systematic reviews Ann John
title_short	Effectiveness of suicide means restriction: an overview of systematic reviews
title_full	Effectiveness of suicide means restriction: an overview of systematic reviews
title_fullStr	Effectiveness of suicide means restriction: an overview of systematic reviews
title_full_unstemmed	Effectiveness of suicide means restriction: an overview of systematic reviews
title_sort	Effectiveness of suicide means restriction: an overview of systematic reviews
author_id_str_mv	ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv	ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author	Ann John
author2	Sarah Steeg Sarah Ledden Lisa Marzano Rina Dutta Leah Quinlivan Nav Kapur Ann John Roger Thomas Webb
format	Journal article
container_title	BMJ Mental Health
container_volume	28
container_issue	1
container_start_page	e302069
publishDate	2025
institution	Swansea University
issn	2755-9734
doi_str_mv	10.1136/bmjment-2025-302069
publisher	BMJ
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str	1
active_str	0
description	Question Means restriction for suicide prevention at a population level typically involves policy or environmental changes to limit access to suicide methods. Several systematic reviews of suicide means restriction exist. This umbrella review aimed to synthesise their findings, assess evidence quality, quantify primary study overlap and identify evidence gaps.Study selection and analysis Searches were conducted across Web of Science, Ovid (PsycINFO, EMBASE), Cochrane and PubMed, supplemented by reference list screening. Study quality was assessed using A MeaSurement Tool to Assess systematic Reviews-2. Study overlap was calculated using the corrected covered area.Findings We included 20 systematic reviews, synthesising evidence from 179 unique primary studies. Physical barriers to prevent jumping showed strong effect sizes, although primary study overlap was high. Train platform screen doors were associated with reduced site-specific suicide mortality, with no evidence of displacement to other sites, although the number of studies was small. Paracetamol pack size limitation reduced self-poisoning admissions, with mixed impacts on mortality. Bans on highly hazardous pesticides reduced suicide rates. More recent reviews suggest firearms restrictions may reduce suicides, but with small effect sizes and methodological limitations. Evidence quality ranged from high to critically low (12/20 rated as critically low). With the exception of pesticide restrictions, lower and middle-income settings were not represented.Conclusions Several means restriction approaches demonstrate effectiveness, although high study overlap and variable study quality were evident. A focus on differential impacts across sociodemographic groups, more evidence from lower and middle-income countries and evidence for suicide prevention on roads and from residential buildings is needed.
published_date	2025-12-09T05:34:06Z
_version_	1856896443687632896
score	11.095902

Effectiveness of suicide means restriction: an overview of systematic reviews

Similar Items