Treatment Strategies for Adolescent Suicide Attempters

Caring for adolescents with mental health problems: Challenges in the emergency department

“…Adult or adolescent patients have poor compliance with referrals for outpatient psychiatric treatment 14 . Therefore, follow up should be actively arranged prior to discharge from the ED rather than left in the hands of the patient and family, appointments should be arranged for within 24–48 h following discharge and assertive follow up should encourage attendance at ongoing care 4,16 . Additional strategies thought to improve treatment adherence in the aftercare of adolescent suicide attempters are 24‐h clinical back‐up for emergencies, vigorous attempts to contact non‐attenders, explicit contracting about the nature of treatment and involvement of family members and significant other people in the treatment 16 .…”

Can receipt of a regular postcard reduce suicide‐related behaviour in young help seekers? A randomized controlled trial

“…However, this type of intervention has not proved to be effective in reducing all forms of self‐harming behaviour, 11 nor with all populations 12 . Further, interventions successful with adults may not be successful among young people 13 …”

“…12 Further, interventions successful with adults may not be successful among young people. 13 A study at a specialist youth mental health service (Orygen Youth Health (OYH)) showed that many young people who were not unwell enough to meet entry criteria had made a recent SA (n = 14; 25%) or expressed SI (n = 22; 38.6%), and when assessed 2 years later, the rates of both SI and SA remained elevated when compared with those who received treatment. 14 Given that past suicide-related behaviour is the strongest indicator of future suicide, 15 these data highlight a service provision gap that could potentially be filled by a brief, low-cost intervention such as a postcard.…”

Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition

“…Such ‘standard’ treatment is usually developed through clinical wisdom and adopted by consensus, but rarely supported by empirical evidence. The term ‘standard aftercare’ is a misnomer, since there is considerable heterogeneity in the aftercare of adolescent suicide attempters, determined by contextual factors such as the availability of treatment resources, financing of medical services, and defence against litigation [5].…”

“…Doubts have been raised about the capacity of service systems to engage and follow‐up young people after presentation to services and a re‐organization of mental health services for adolescents, to make them more responsive to crises that typically occur after hours is well overdue [5−8]. Available data indicates that adherence rates with follow‐up for non‐hospitalized adolescents presenting with deliberate self‐harm (DSH) range between 20 and 30% of all cases [9,10].…”