Brief Suicide Prevention Interventions in Acute Care Settings May Reduce Subsequent Suicide AttemptsSeptember 16, 2020
National Institute of Mental Health
Suicide is the tenth leading cause of death in the United States, and rates of suicide have been rising in each of the last 15 years. Research has shown that more than one-third of people who die by suicide had a health care encounter in the week before their death, and half within a month before their death. Because of this, health care organizations are well positioned to provide suicide prevention interventions during patient visits. However, clinical teams require evidence-based interventions to address suicide risk directly and ensure that patients transition to ongoing mental health care.
In a research project led by Stephanie K. Doupnik, M.D., and supported by the National Institute of Mental Health, researchers conducted a systematic review of studies (called a meta-analysis) on clinical trials of brief suicide prevention interventions to determine how effective these interventions might be in acute care settings, such as hospitals, emergency departments, and urgent care centers. Their findings were published in JAMA Psychiatry.
The team included 14 studies in the meta-analysis, representing a total of 4,270 patients. The three primary outcomes they examined were: subsequent suicide attempts, linkage to follow-up care, and depression symptoms at follow-up.
The included studies evaluated brief suicide prevention interventions to promote ongoing mental health care and reduce subsequent suicide attempts. The researchers identified studies that included four main components in their interventions: brief contact interventions, care coordination, safety planning interventions, and other brief therapies.
An important future research direction, the researchers wrote, is to identify and test implementation strategies for brief suicide prevention interventions in acute care settings. To do this, the authors suggest that health care settings need robust systems to identify patients with suicide risk, and that clinical teams require access to mental health professionals with skills and expertise to provide brief interventions. They also suggested future research could investigate implementing these kinds of interventions in acute care settings outside of traditional health care, like jails and crisis homeless shelters.