Le soutien psychologique des militaires et vétérans représente un enjeu de santé publique au niveau international. En ce sens, considérant les études en population générale sur la prévention du suicide, les lignes téléphoniques de crise semblent être des dispositifs d’intérêt. Cependant, il n’existe pas de données de synthèse concernant l’effet de ces lignes chez les militaires et les vétérans. Ce travail visait à évaluer l’impact des lignes de crise sur la santé mentale des vétérans et militaires américains.

A travers PubMed/MEDLINE et Web of Science, nous avons effectué une recherche systématique d’études ayant évalué l’impact à court ou long terme, d’une ligne téléphonique de crise sur la santé mentale des vétérans et militaires américains. Nous nous sommes basés sur les éléments du PRISMA ( Preferred Reporting Items for Systematic reviews and Meta-Analyses ) 2020.

Sur les 273 articles initiaux, six ont finalement ont été intégrés à notre revue. Toutes les études ont montré des effets bénéfiques des lignes de crise sur la santé mentale des militaires et vétérans, dont une diminution significative des idées suicidaires et une amélioration significative de l’adhésion aux soins ultérieurs de santé mentale. Le risque de biais était élevé pour deux études, et modéré pour quatre.

Les résultats de ce travail illustrent le bénéfice potentiel des lignes de crise sur des militaires et vétérans, en l’occurrence américains. Il nous semble intéressant de confirmer ces données par des études sur d’autres populations de militaires/vétérans à travers le monde, notamment en France.

Providing mental health and psychological support to military personnel and veterans is a global public health challenge given the prevalence of wars and conflicts around the world and the threat of terrorist attacks. In this context, mental health crisis lines are of interest, and have been widely studied in the general population, particularly for suicide prevention. However, to our knowledge, there has been no synthesis published on the impact of these lines on the psychological wellbeing of military personnel and veterans. Therefore, the aim of this review was to examine the impact of crisis lines on the mental health of US military personnel and veterans.

After registering our protocol with the International Prospective Register of Systematic Reviews (PROSPERO number = CRD42024564800), we systematically searched PubMed/MEDLINE and Web of Science for relevant articles published up to 18 June 2024. As outcomes of interest in eligible studies, we targeted the short-term effects (e.g., suicidal ideation) and medium- to long-term consequences (e.g., subsequent adherence to mental healthcare) of veterans’ contacts with crisis hotline (phone calls, chat, and text messages). We assessed the methodological quality of the included studies using ROBINS-E (Risk of Bias in Non-randomized Studies–of Exposure) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines.

Of the 273 articles initially identified, six were included in our review. Sample sizes ranged from 155 to 9010, with a total of 11,401 participants, a male predominance, and a mean age from 46 to 50 years (three studies). Most of included studies (five on six) used national database. Three studies examined the referrals for care provided following each call. Two studies focused specifically on the effect on suicidal thoughts, and one study examined the rate of care engagement following a call. The effect of crisis lines was found to be positive for each outcome, according to the respective studies. Specifically, there were significant reductions in psychological distress and suicidal ideations, and a positive effect on subsequent adherence to mental health care. The risk of bias was high in two studies and moderate in the other four. The domains that showed the most concern and bias were those related to confounding factors and missing data.

The promising results of this review on US military personnel and veterans highlight the potential benefits of crisis lines for armed forces. It seems valuable to strengthen these findings with studies involving other military/veteran populations worldwide, particularly in France.