Can Postdischarge Follow-Up Contacts Prevent Suicide and Suicidal Behavior?
ABSTRACT 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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- "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 (veteranscrisisline.net), the National Suicide Prevention Lifeline (http://www.suicidepreventionlifeline.org), and comparable resources for U.S. military personnel. "
ABSTRACT: Suicidal ideation and behavior have been associated with a variety of neurological illnesses. Studies are ongoing in combat veterans and other groups to examine possible mechanisms and pathways that account for such associations. This article provides a review of the literature on suicide ideation and suicidal behavior in patients with neurological illnesses including publications on veteran's health and military medicine. Studies of suicide attempts and deaths in people with neurological illnesses are also reviewed. The studies summarized in this review indicate that there are important linkages between suicidal ideation and behavior and neurological conditions, including epilepsy, multiple sclerosis, and amyotrophic lateral sclerosis. Additional studies are needed to further clarify why suicide ideation and suicidal behavior are associated with neurological diseases, in order to improve quality of life, alleviate patient distress, and prevent nonfatal and fatal suicide attempts in veteran and non-veteran populations.04/2013; Suppl 9(1). DOI:10.4172/2167-1044.S9-001
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ABSTRACT: OBJECTIVE The rising rate of suicide and the increase in psychiatric hospitalizations in the U.S. military underscore the need to determine risk among service members in psychiatric care so that targeted interventions and prevention programs are implemented. The purpose of this study was to determine the suicide rates of active-duty U.S. service members after discharge from a psychiatric hospitalization. METHODS Data from 68,947 patients who had psychiatric hospitalizations at military treatment facilities between 2001 and 2011 were obtained from the Defense Medical Surveillance System. Rates of suicide were compared between the cohort group and the general active-duty U.S. military population. Survival analysis was used to determine time-dependent patterns of suicide after hospital discharge. RESULTS A total of 153 suicides occurred among the 68,947 service members. The overall suicide rate in the cohort was 71.6 per 100,000 person-years, compared with the rate of 14.2 per 100,000 person-years in the general active-duty U.S. military population. Personnel released from a psychiatric hospitalization were therefore five times more likely to die from suicide. The risk of dying from suicide within the first 30 days after a psychiatric hospitalization was 8.2 times higher than the risk at more than one year after hospitalization. CONCLUSIONS Active-duty U.S. service members who are released from a psychiatric hospitalization are a group at high risk of suicide. Aggressive safety planning and targeted interventions during and after hospitalization are recommended.Psychiatric services (Washington, D.C.) 05/2013; 64(7). DOI:10.1176/appi.ps.201200413 · 1.99 Impact Factor
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ABSTRACT: Home-based telemental health (HBTMH) has several important benefits for both patients and clinical practitioners including improved access to services, convenience, flexibility, and potential cost savings. HBTMH also has the potential to offer additional clinical benefits that are not realized with traditional in-office alternatives. Through a review of the empirical literature, this article presents and evaluates evidence of the clinical benefits and limitations of HBTMH. Particular topics include treatment attendance and satisfaction, social support, access to contextual information, patient and practitioner safety, and concerns about privacy and stigma. By making use of commonly available communication technologies, HBTMH affords opportunities to bridge gaps in care to meet current and future mental health care needs.Professional Psychology Research and Practice 10/2014; 45(5):340-346. DOI:10.1037/a0035461 · 1.34 Impact Factor