Social support and suicidal ideation in Japan: Are home visits by commissioned welfare volunteers associated with a lower risk of suicidal ideation among elderly people in the community?

Aims: Social support has consistently been reported to be effective in reducing suicidal ideation. This cross-sectional study was performed to determine whether home visits by commissioned welfare volunteers (i.e., organizations of community residents appointed by national or prefectural governments) are associated with a lower risk of suicidal ideation among the elderly. Methods: In August 2010, questionnaires were sent to all residents aged ≥ 65 years in three municipalities (n = 21,232) in Okayama prefecture, Japan, and 13,929 returned the questionnaire (response rate: 65.6 %). We finally analyzed 11,218 subjects. Both home visits by commissioned welfare volunteers and suicidal ideation within the last 30 days were assessed in the questionnaire. Odds ratios (ORs) and 95 % confidence intervals (CIs) for suicidal ideation were calculated adjusting for age, sex, educational attainment, and marital status. We then additionally adjusted for instrumental and emotional support, separately. Results: The prevalence of suicidal ideation was 10.0 % and higher in women than in men (11.4 % vs. 8.0 %). Home visits were significantly associated with a lower risk of suicidal ideation after adjusting for instrumental and emotional support, respectively (OR: 0.60, 95 % CI: 0.53-0.69; OR: 0.67, 95 % CI: 0.59-0.78). In sex-stratified analysis, the association was clearer for women than for men: the corresponding ORs among women were 0.55 (95 % CI: 0.46-0.65) and 0.61 (95 % CI: 0.52-0.73), whereas they were 0.71 (95 % CI: 0.56-0.90) and 0.78 (95 % CI: 0.61-0.99) among men. Conclusion: Our findings suggest that home visits by commissioned welfare volunteers are significantly associated with lower suicidal ideation among the elderly, particularly in women.