Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study

Abstract

BackgroundAttempted suicide is a major public health problem, and the efficacies of current postvention protocols vary. We evaluated the effectiveness of telephone follow-up of patients referred to an emergency psychiatric unit for attempted suicide on any further attempt/s over the following year.MethodIn a single-center, controlled study with intent to treat, we evaluated the efficacy of a protocol of telephone follow-up of 436 patients at 8, 30, and 60 days after they were treated for attempted suicide. As controls for comparison, we evaluated patients with similar social and demographic characteristics referred to our emergency psychiatric unit in the year prior to the study who did not receive telephone follow-up after their initial hospitalization. Data were analyzed using logistic regression.ResultsVery early telephone follow-up of our patients effectively reduced recidivism and seemed to be the only protective factor against repeated suicide attempt.ConclusionsImplementing a protocol of early telephone follow-up after attempted suicide could help prevent repeated attempt/s. More controlled studies are needed to assess optimal techniques to prevent such repetition.

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

“…Discharge from acute mental health services is often described as a dangerous, chaotic, and emotionally driven time-period for patients (1). This time period has long been associated with mortality, risk, and related adverse outcomes for patients (2)(3)(4)(5). In England, between 2006 and 2016, there were 2,220 suicides within 3 months of discharge from inpatient mental health care (2).…”

Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide to China: a Delphi expert consensus study

“…Therefore, besides taking an individual's history of attempted suicide as the warning signs and risk factors for suicide as the English guidelines did, it is needed to include additional actions specifically used to address issues related to repeated suicidal attempts among Chinese people (e.g. to detect long-lasting relationship conflicts, ongoing mental health problems, or inappropriate problem-solving strategy), in order to prevent subsequent attempts and the risk of death from suicide [39].…”

Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis

“…Of the studies that aimed to reduce suicide, one found letters to recently discharged service users ineffective [6]. Whilst the other found only very early telephone follow-ups to be effective in a large-scale randomised controlled trial [5]. A small-scale RCT found intensive case management (weekly face-to-face contact and suicidal ideation and suicidal ideation and increased service contact, satisfaction and better relationships with professionals [34].…”

“…Only three studies in the review focused on reducing suicide post-discharge [5,6,34]. In the unsuccessful intervention 8 letters were sent to service users in the year after discharge, but this had no effect on suicide [6].…”

“…Research shows, for example, that between 2005 and 2015 seventeen percent of people who took their own life had recently been discharged from acute hospital services [4]. The significance of suicide as a marker of quality during and after acute care is further indicated by its routine use in many studies and evaluations of interventions to support hospital discharge, alongside other measures such as readmission and length of stay [5][6][7][8]. However, the variety of challenges that are present at this sensitive time in the service user journey transverse far beyond what can be measured solely using readmission or death by suicide rates.…”