New intervention benefits suicidal ED patients, lowers suicide attempts

A multifaceted intervention helped reduce the number of suicides among suicidal emergency department patients, a new clinical trial shows. JAMA Psychiatry published the results of the trial that involved researchers from Providence, R.I.-based Brown University, Amherst-based University of Massachusetts and Boston-based Massachusetts General Hospital/Harvard University.

The trial involved three phases creating three comparison groups. The first phase, August 2010 to December 2011, included 497 patients receiving each participating ED's usual treatment — this was the control group. In the second phase, September 2011 to December 2012, 377 patients received additional suicide screening. The third phase, July 2012 to November 2013, involved 502 patients receiving the multifaceted intervention.

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The multifaceted intervention included:

•    Additional suicide screening
•    Suicide prevention information from nurses
•    Personal safety plans

Additionally, they received periodic phone calls from providers to discuss suicide risk factors, future planning and treatment engagement. The intervention also included the involvement of a loved one whenever possible.

The number of suicide attempts and the proportion of people attempting suicide decreased significantly in the intervention group as compared to the control group. The group that only received the additional screening did not show a decrease in suicide attempt rates in comparison with the control group.

The research team is currently conducting a cost-effectiveness analysis for the multifaceted intervention.

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