Suicide prevention in primary health care among socially vulnerable populations: a narrative review.

Introduction: Suicide remains a major public health challenge worldwide, particularly among socially vulnerable populations who experience disproportionate exposure to social determinants associated with suicide risk and barriers to mental healthcare. Primary health care (PHC) is often the first point of contact with healthcare services and therefore plays a critical role in suicide prevention. Methods: This narrative review was conducted according to the SANRA guidelines. A structured literature search of PubMed/MEDLINE, Scopus, and Web of Science was performed to identify evidence on suicide prevention interventions implemented in PHC and their applicability to socially vulnerable populations. The review focused on intervention characteristics, implementation approaches, reported outcomes, and challenges relevant to PHC practice. Results: The reviewed literature indicates that suicide prevention in PHC relies on multiple complementary strategies, including suicide risk screening, collaborative care models, safety planning interventions, brief psychological interventions, telehealth approaches, continuity-of-care programs, and provider training. Evidence suggests that multicomponent and integrated approaches are generally more effective than isolated interventions. Socially vulnerable populations, including people experiencing homelessness, poverty, unemployment, migration, domestic violence, substance use disorders, social isolation, disability, and social marginalization, face additional barriers to accessing mental healthcare and suicide prevention services. Effective interventions frequently combine clinical care with community, social, and support services to address both mental health needs and underlying social determinants of suicide risk. Conclusion: Suicide prevention in PHC requires integrated, multidisciplinary, and person-centered approaches that extend beyond risk identification alone. Strengthening service integration, continuity of care, provider capacity, and intersectoral collaboration may improve suicide prevention efforts, particularly among socially vulnerable populations. Further research is needed to evaluate implementation strategies and intervention effectiveness in diverse healthcare settings, especially in low- and middle-income countries.