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

BACKGROUND Previous short-term work reported fewer suicides among elderly users of a telephone helpline and emergency response service (the TeleHelp-TeleCheck 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 24h 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; chi(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; chi(2)=8.36, d.f.=1, P<0.001). CONCLUSIONS The study confirms the initial promise of the TeleHelp-TeleCheck service over a much longer time period. Further research will clarify the apparent lack of benefit for elderly males.