Oyama et al's Community-Based Prevention for Suicide in Elderly by Depression Screening and Follow-U

Oyama et al's Community-Based Prevention for Suicide in Elderly by Depression Screening and Follow-U

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Community Mental Health Journal, Vol. 40, No. 3, June 2004 ( 2004) Community-Based Prevention for Suicide in Elderly by Depression Screening and Follow-Up Hirofumi Oyama, M.D., Ph.D. Junichi Koida, M.D., Ph.D. Tomoe Sakashita, M.A. Keiko Kudo, P.H.N. ABSTRACT: The aim of the study was to evaluate the outcome of a community-based prevention program against suicides among the elderly aged 65 and over in the Japanese rural town of Joboji (population 7,010), using a quasi-experimental design with two neighboring control areas. During the 10-year implementation of the program based on strategies including screening for depression, follow up with mental health care or psychiatric treatment and health education on depression, the relative risks estimated by the age-adjusted odds ratios for both males and females were reduced to almost one quarter more than a regional historical trend, with a better response to education for females than for males. A community-based management for later-life depression with mental health care supported by the psychiatric treatment can be effective against suicide among the elderly for both males and females. KEY WORDS: suicide prevention; community-based intervention; elderly; depression screening; health education. Hirofumi Oyama is in the Department of Human Welfare, Ritsumeikan University, Kyoto, Japan. Junichi Koida is in the Department of Psychiatry, Iwate Prefectural Ichinohe Hospital. Keiko Kudo is in the Division of Health and Welfare, Joboji Town. Tomoe Sakashita is in the Department of Human Welfare, Ritsumeikan University, Kyoto, Japan. Address correspondence to Hirofumi Oyama, M.D., Ph.D., Department of Human Welfare, Ritsu- meikan University, 56-1 Tojiin-Kitamachi, Kita-ku, Kyoto 603-8577, Japan; e-mail: [email protected] .ritsumei.ac.jp. 249 2004 Human Sciences Press, Inc.
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Community Mental Health Journal 250 INTRODUCTION The suicide problem among the aged in Asia including Japan is more serious than among their Western counterparts. While the Japanese now have the longest average life span in the world, the suicide rate among the individuals aged 65 and over has kept higher than other aged groups. Although individuals aged 65 and over accounted for 12% of the total population of Japan in 1990, suicides in its group consisted of 29% of all suicides (Takahashi, 1993). A regional differ- ence in the elderly suicide rate is also seen, with the rate being higher in agricultural rural areas than in urban areas in Japan (Ono et al., 2001). In addition, Matsumoto recently demonstrated that the local socio-demographic factors including depopulation, an increasing pro- portion of the elderly population, an agricultural key industry, an inland situation and the poor use of the social welfare service for the elderly were the major sociologic determinants of the enhancing suicide rate among the elderly in the Japanese municipalities (Matsu- moto, 2001).
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