Reducing the risk of late-life suicide through improved depression care

On September 14th, 2006, the United States Senate Special Committee on Aging conducted a hearing titled, "Generation at Risk: Breaking the Cycle of Senior Suicide," in which chairman Smith called late-life suicide an epidemic. Both Senator Gordon H. Smith and colleague Senator Herb Kohl emphasized the contribution of mental illness, specifically depression, as a preventable cause of suicide among older Americans. They both emphasized primary care settings as the logical avenue through which improvements in depression care could lead to reduced rates of suicide in old age. However, if late-life depression in primary care is the target, what characterizes effective interventions, and how effective are they? What follows is a review of studies which evaluated efforts to reduce suicidality through improved depression care in primary practice settings.