Can Postdischarge Follow-Up Contacts Prevent Suicide and Suicidal Behavior?

National Center for Telehealth & Technology (T2), Joint Base Lewis-McChord, WA, USA Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
Crisis The Journal of Crisis Intervention and Suicide Prevention (Impact Factor: 1.09). 07/2012; 34(1):1-10. DOI: 10.1027/0227-5910/a000158
Source: PubMed


Background: The time period following discharge from inpatient psychiatry and emergency department (ED) treatment is one of heightened risk for repeat suicide attempts for patients. Evidence reported in the literature shows that follow-up contacts might reduce suicide risk, although there has not been a comprehensive and critical review of the evidence to date. Aims: To evaluate evidence for the effectiveness of suicide prevention interventions that involve follow-up contacts with patients. Methods: Published empirical studies of follow-up interventions with suicidal behaviors (suicide, attempts, and ideation) as outcomes were searched. Study populations were inpatient psychiatric or ED patients being discharged to home. Contact modalities included phone, postal letter, postcards, in-person, and technology-based methods (e-mail and texting). Results: Eight original studies, two follow-up studies, and one secondary analysis study met inclusion criteria. Five studies showed a statistically significant reduction in suicidal behavior. Four studies showed mixed results with trends toward a preventative effect and two studies did not show a preventative effect. Conclusions: Repeated follow-up contacts appear to reduce suicidal behavior. More research is needed, however, especially randomized controlled trials, to determine what specific factors might make follow-up contact modalities or methods more effective than others.

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    • "), but it seems that follow-up contact after psychiatric hospitalization might be a good strategy to pursue (Luxton et al., 2013). The Czech Republic, despite of being a high-income country, is among the European countries that do not have a national suicide prevention strategy. "
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    ABSTRACT: Research shows the elevated risk of suicide associated with current or recent inpatient psychiatric hospitalization. However, it is unclear whether this applies in the area of post-communist Central and Eastern Europe where mental health care has not been deinstitutionalized yet. The present study aims to examine the rates of suicides among psychiatric patients during and shortly after discharge from inpatient hospitalization in the Czech Republic. All inpatient psychiatric hospitalizations and all suicides committed between 2008 and 2012 have been merged on an individual data basis. The time horizon between the admission and two months after the discharge from inpatient psychiatric facility was utilized and multiple logistic regression was performed to calculate the odds of committing suicide. A total of 137,290 inpatients were hospitalized in Czech psychiatric facilities between 2008 and 2012, and 402 of the inpatients committed suicide during the hospitalization or within the 2 months after the discharge. Highly elevated risks of suicides were found to be associated with being a male, having a history of multiple hospitalizations, and having a diagnosis of affective, anxiety, or personality disorder. Limitations are related to the design of the study, and its reliance on routinely collected data. Also, it was not possible to assess the odds of suicide associated with inpatient psychiatric hospitalization against the odds of suicide in general population. During psychiatric treatment and recovery, suicial behavior and idealiation is increased. In psychiatry, hospitalization may be a risky period for suicide behavior. Suicide rates during and soon after the psychiatric hospitalization identified in this study from Central and Eastern Europe are similar to the findings from Western Europe. Preventive strategies should be tailored accordingly. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 09/2015; 184. DOI:10.1016/j.jad.2015.05.039 · 3.38 Impact Factor
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    • "Adherence with recommended treatments is also important. A variety of strategies have been proposed to encourage people experiencing suicidal ideation or intent to seek help, to provide referrals, and to improve referral follow-through and attendance [18,121,122]. In the U.S., these strategies include a national network of suicide prevention crisis lines, including the VA national crisis line (, the National Suicide Prevention Lifeline (, and comparable resources for U.S. military personnel. "
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    04/2013; Suppl 9(1). DOI:10.4172/2167-1044.S9-001

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