Family Interventions for Suicide and Self-Harm: A Scoping Review of Definitions, Populations, and Approaches

Abstract Background. Most people who experience suicidal behaviour or self-harm live within families and kinship networks, yet prevention remains largely individual-focused. This review mapped the definitions, populations, and approaches of family-based interventions for suicide and self-harm, and whether these interventions were co-designed. Methods. A scoping review searched nine electronic databases. Eligible studies were published in English and reported a suicide or self-harm intervention involving at least one family member. A broad, culturally inclusive operational definition of family was applied, and studies were not required to define family themselves. Extraction captured intervention types, settings, durations, definitions of family, participating members, rationales for involvement, co-design, and population coverage. Results. In total, 135 studies were included. Family-based therapy (18.5%), means restriction or safe storage (15.6%), and psychoeducation or gatekeeper training (11.9%) were the most common approaches. Only four studies (3.0%) explicitly defined family, although 92 (68.1%) articulated a rationale for family involvement. Parents or caregivers participated in 79.3% of studies. Where gender was reported, mothers comprised a mean of 72.2% of caregiving samples and fathers 26.8%. Full or consultative co-design was rare (approximately 7%), mostly used in digital and Indigenous programmes. Most interventions targeted children, adolescents, and young people (82.2%). Adults, older people, and perinatal populations were rarely addressed. Limitations. Findings are constrained by primary-study heterogeneity, English-language restriction, and single-reviewer screening with 20% verification of extraction. Conclusions. Family-based interventions are widely used but remain conceptually underdeveloped. Researchers who define family explicitly, engage a more diverse range of caregivers, and build in co-design from the outset will be better placed to establish the equity and real-world impact of these interventions.