Existential factors such as loss of meaning play a central role in suicide-related vulnerability, yet most prevention interventions target symptom reduction. We aimed to systematically review the effects of meaning-based interventions on suicide-related outcomes and characterize the mechanisms through which these effects operate.

A systematic review was conducted following PRISMA 2020 guidelines. Six databases (PubMed, Web of Science, CINAHL, PsycINFO, Research Information Sharing Service, and Korean Studies Information Service System) were searched from inception to April 2026. Studies were included if they evaluated meaning-based interventions and reported suicide-related outcomes. Risk of bias was assessed using RoB 2 for randomized trials and RoBANS for nonrandomized studies. Given heterogeneity across populations, interventions, and outcomes, findings were synthesized narratively by domain.

Ten studies were included (7 randomized controlled trials, 2 quasi-experimental studies, and 1 secondary analysis). Meaning-based interventions most consistently improved existential outcomes, including meaning in life, spiritual well-being, and quality of life. Emotional outcomes showed partial and heterogeneous effects. Suicide-related outcomes, including hopelessness, demoralization, and suicidal ideation, generally showed reductions, although effects varied across studies. Mechanistically, most studies showed patterns of indirect pathways, whereby improvements in existential variables co-occurred with reductions in emotional and suicide-related outcomes.

Meaning-based interventions may reduce suicide-related vulnerability primarily by enhancing existential resources rather than directly targeting symptoms. These findings support integrating meaning-centered approaches into suicide prevention strategies and highlight the need for longitudinal and mediation-based studies to examine causal mechanisms.