Suicide is a critical public health issue, particularly among vulnerable populations of all ages living in slums. People residing in these environments often face unique psychosocial challenges that contribute to elevated rates of suicidal ideation and behavior. This study aims to consider the strategies and implementation considerations for suicide prevention programs in slums.
Methods
A systematic scoping review was conducted according to Arksey and O’Malley’s framework in 2024. Multiple electronic databases were searched systematically to identify studies focusing on suicide prevention strategies in slum populations. Studies were selected based on their relevance to suicide prevention, risk factors, and considerations for implementation. A narrative synthesis approach was applied to summarize the findings from the included studies.
Results
A total of 15 studies were included from an initial search of 3914 records screened. Synthesis of findings led to the identification of suicide control strategies for some target groups, including the general population, individuals at risk, and individuals with warning signs or previous suicide attempts. The strategies can be considered in the form of primary, secondary, and tertiary prevention. Strategies focus on enhancing mental health services access, promoting community awareness, reducing access to lethal means, and providing responsive crisis services.
Conclusion
Addressing suicide prevention in slum areas requires a multifaceted approach that considers the unique socio-economic contexts of these communities. Community-based interventions, enhanced healthcare access, and targeted mental health programs, adapted to the unique resource and structural constraints of slum environments, are crucial for reducing the incidence of suicidal ideation and behaviors.
Programme UNHS. The challenge of slums: global report on human settlements, 2003. Routledge, 2003.
2.
UN Habitat. SDG 11: sustainable cities and make cities and human settlements inclusive, safe, resilient and sustainable communities. United Nations: Department of Economic and Social Affairs, 2023.
3.
DuanWRenJYangS, et al.Intra-city differentiation patterns and typological governance strategies for urban villages in Kunming: empirical evidence from 140 case studies. Buildings2025; 15(16): 2943. https://doi.org/10.3390/buildings15162943
4.
KavisheNZuluSMusondaI, et al. Investigating challenges in achieving sustainable urban infrastructure development in informal settlements. Smart Sustain Built Environ. 2025; ahead-of-print: 1. https://doi.org/10.1108/sasbe-07-2024-0256
5.
United Nations Statistics Division. Make cities and human settlements inclusive, safe, resilient and sustainable. Department of Economic and Social Affairs. https://unstats.un.org/sdgs/report/2023/goal-11/
6.
RaoofiAAmirkhaniMMonjazebM, et al.The slums in the mirror of health: a systematic review analysis from Iran. Int J Prev Med2022; 13(1): 137. https://doi.org/10.4103/ijpvm.ijpvm_71_21
7.
CulbrethRSwahnMHNdeteiD, et al. Suicidal ideation among youth living in the slums of Kampala, Uganda. Int J Environ Res Publ Health. 2018; 15(2): 298. https://doi.org/10.3390/ijerph15020298
8.
JorgejaberCSoaresVZanelattoP, et al.Suicide prevention project with young people in the Rocinha slum in Rio de Janeiro. Eur Psychiatry2024; 67: S779. https://doi.org/10.1192/j.eurpsy.2024.1622
9.
BukulukiPWandiembeSKisaakyeP, et al.Suicidal ideations and attempts among adolescents in Kampala urban settlements in Uganda: a case study of adolescents receiving care from the Uganda youth development link. Front Sociol2021; 6: 6646854. https://doi.org/10.3389/fsoc.2021.646854
10.
LeeHParkCHKRheeSJ, et al.The influence of poverty attribution on attitudes toward suicide and suicidal thought: a cross-national comparison between South Korean, Japanese, and American populations. Compr Psychiatry2021; 109: 152259. https://doi.org/10.1016/j.comppsych.2021.152259
11.
PawarNKumarNVikramA, et al.Depression and its socio-demographic correlates among urban slum dwellers of North India: a cross-sectional study. J Fam Med Prim Care2022; 11(6): 2369–2376. https://doi.org/10.4103/jfmpc.jfmpc_616_21
12.
SwahnMHPalmierJBKasiryeR, et al.Correlates of suicide ideation and attempt among youth living in the slums of Kampala. Int J Environ Res Publ Health2012; 9(2): 596–609. https://doi.org/10.3390/ijerph9020596
13.
ParkarSRNagarsekarBWeissMG. Explaining suicide in an urban slum of Mumbai, India: a sociocultural autopsy. Crisis2009; 30(4): 192–201. https://doi.org/10.1027/0227-5910.30.4.192
KimHYNamEWJinKN, et al.Effectiveness of a school-based mental health education program in an impoverished urban area of Peru. Glob Health Promot2020; 27(1): 77–86. https://doi.org/10.1177/1757975918786728
16.
Godoy-GarrazaLCamposSWalrathC. Using a spatiotemporal model to estimate the impact of suicide prevention in small areas. Health Serv Outcome Res Methodol2021; 21(4): 510–526. https://doi.org/10.1007/s10742-021-00242-y
WeissmanRSScottBGEdwardsK, et al.Adapting a youth suicide prevention program for rural communities in the United States: a feasibility study. Discover Psychology2024; 4(1): 27. https://doi.org/10.1007/s44202-024-00140-7
19.
AlvesFJOMachadoDBBarretoML. Effect of the Brazilian cash transfer programme on suicide rates: a longitudinal analysis of the Brazilian municipalities. Soc Psychiatr Psychiatr Epidemiol2019; 54(5): 599–606. https://doi.org/10.1007/s00127-018-1627-6
20.
DamianoRFBeiramLDamianoBBF, et al.Associations between a Brazilian suicide awareness campaign and suicide trends from 2000 to 2019: joinpoint and regression discontinuity analysis. J Affect Disord2024; 365: 459–465. https://doi.org/10.1016/j.jad.2024.08.134
21.
JenkinsRMussaMHajiSA, et al.Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa. Int J Ment Health Syst2011; 5: 6. https://doi.org/10.1186/1752-4458-5-6
22.
OcchipintiJASkinnerAIorfinoF, et al.Reducing youth suicide: systems modelling and simulation to guide targeted investments across the determinants. BMC Med2021; 19(1): 61. https://doi.org/10.1186/s12916-021-01935-4
23.
JacksonJFarrMBirnieK, et al.Preventing male suicide through a psychosocial intervention that provides psychological support and tackles financial difficulties: a mixed method evaluation. Article. BMC Psychiatry2022; 22(1): 333. https://doi.org/10.1186/s12888-022-03973-5
24.
SinghARSinghSA. Towards a suicide free society: identify suicide prevention as public health policy. Mens Sana Monogr2004; 2(1): 21–33.
25.
MukherjeeAYatirajulaSKKallakuriS, et al.Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study. Child Adolesc Psychiatr Ment Health2024; 18(1): 14. https://doi.org/10.1186/s13034-024-00704-4
26.
BagleyCAShahnazASimkhadaP. High rates of suicide and violence in the lives of girls and young women in Bangladesh: issues for feminist intervention. Soc Sci2017; 6(4): 140. https://doi.org/10.3390/socsci6040140
27.
Productivity Commission. Mental health: providing choice for culturally and linguistically diverse communities. Canberra: Australian Government, 2020, Vol. 1.
28.
BassiliosBNicholasAReifelsL, et al.Achievements of the Australian Access to Allied Psychological Services (ATAPS) program: summarising (almost) a decade of key evaluation data. Int J Ment Health Syst2016; 10: 1–13. https://doi.org/10.1186/s13033-016-0092-4
29.
PadillaAThakurADrazbaA, et al.Suicide prevention for underserved populations and community mental health. In: Suicide Risk Assessment and Prevention. Springer, 2022, pp. 1–23.
30.
HegerlURummel-KlugeCVärnikA, et al.Alliances against depression–a community based approach to target depression and to prevent suicidal behaviour. Neurosci Biobehav Rev2013; 37(10): 2404–2409. https://doi.org/10.1016/j.neubiorev.2013.02.009
KeynejadRSpagnoloJThornicroftG. WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact. BMJ Ment Health2021; 24(3): 124–130. https://doi.org/10.1136/ebmental-2021-300254
33.
GronholmPCMakhmudABarbuiC, et al.Qualitative evidence regarding the experience of receiving and providing care for mental health conditions in non-specialist settings in low-income and middle-income countries: a systematic review of reviews. BMJ Ment Health2023; 26(1): e300755. https://doi.org/10.1136/bmjment-2023-300755
34.
MehrolhasaniMHYazdi-FeyzabadiVGhasemiS. Community empowerment for health promotion in slums areas: a narrative review with emphasis on challenges and interventions. J Educ Health Promot2021; 10(1): 263. https://doi.org/10.4103/jehp.jehp_1628_20
35.
YatirajulaSKKallakuriSPaslawarS, et al.An intervention to reduce stigma and improve management of depression, risk of suicide/self-harm and other significant emotional or medically unexplained complaints among adolescents living in urban slums: protocol for the ARTEMIS project. Trials2022; 23(1): 612. https://doi.org/10.1186/s13063-022-06539-8
36.
ShahwanSGohCMJTanGTH, et al.Strategies to reduce mental illness stigma: perspectives of people with lived experience and caregivers. Int J Environ Res Publ Health2022; 19(3): 1632. https://doi.org/10.3390/ijerph19031632
37.
FongTHMakWW. The effects of internet-based storytelling programs (amazing adventure against stigma) in reducing mental illness stigma with mediation by interactivity and stigma content: randomized controlled trial. J Med Internet Res2022; 24(8): e37973. https://doi.org/10.2196/37973
HoffbergASStearns-YoderKABrennerLA. The effectiveness of crisis line services: a systematic review. Front Public Health2020; 7: 399. https://doi.org/10.3389/fpubh.2019.00399
40.
ZabelskiSKaniukaARRobertson RA, et al.Crisis lines: current status and recommendations for research and policy. Psychiatr Serv2023; 74(5): 505–512. https://doi.org/10.1176/appi.ps.20220294
41.
MeliaRFrancisKHickeyE, et al.Mobile health technology interventions for suicide prevention: systematic review. JMIR mHealth uHealth2020; 8(1): e12516. https://doi.org/10.2196/12516
42.
McDanielMSundaramSManjanathaD, et al.“They made me feel like I mattered”: a qualitative study of how mobile crisis teams can support people experiencing homelessness. BMC Public Health2024; 24(1): 2183. https://doi.org/10.1186/s12889-024-19596-2
43.
CurrierGWFisherSGCaineED. Mobile crisis team intervention to enhance linkage of discharged suicidal emergency department patients to outpatient psychiatric services: a randomized controlled trial. Acad Emerg Med2010; 17(1): 36–43. https://doi.org/10.1111/j.1553-2712.2009.00619.x
44.
LucchettiSBruscoLIDiez-CansecoF, et al.How are different levels of social media engagement associated with mental distress and quality of life in young people living in deprived urban areas? A cross-sectional study in Bogotá, Buenos Aires and Lima. BMJ Open2025; 15(9): e102466. https://doi.org/10.1136/bmjopen-2025-102466
45.
WondimuH. The subsequent challenges of the slum and squatter settlements: in the city of Addis Ababa. Euro J Res Develop Sustain2021; 2(1): 24–34.
46.
ParkarSRNagarsekarBBWeissMG. Explaining suicide: identifying common themes and diverse perspectives in an urban Mumbai slum. Soc Sci Med2012; 75(11): 2037–2046. https://doi.org/10.1016/j.socscimed.2012.07.002
47.
OnoYSakaiAOtsukaK, et al.Effectiveness of a multimodal community intervention program to prevent suicide and suicide attempts: a quasi-experimental study. PLoS One2013; 8(10): e74902. https://doi.org/10.1371/journal.pone.0074902
48.
HanlonCAMcIlroyDPooleH, et al.Evaluating the role and effectiveness of co‐produced community‐based mental health interventions that aim to reduce suicide among adults: a systematic review. Health Expect2023; 26(1): 64–86. https://doi.org/10.1111/hex.13661
49.
PearceTMapleMWaylandS, et al.A mixed-methods systematic review of suicide prevention interventions involving multisectoral collaborations. Health Res Pol Syst2022; 20(1): 40. https://doi.org/10.1186/s12961-022-00835-0
50.
CaineEDReedJHindmanJ, et al.Comprehensive, integrated approaches to suicide prevention: practical guidance. Inj Prev2018; 24(Suppl 1): i38–i45. https://doi.org/10.1136/injuryprev-2017-042366
51.
Van Der VlietNDen BroederLRomeo-VelillaM, et al.Facilitators and barriers of intersectoral co-operation to promote healthier and more environmentally friendly behaviour: a qualitative evaluation through focus groups for the INHERIT project. BMC Public Health2022; 22(1): 617. https://doi.org/10.1186/s12889-022-12974-8
