Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries

Author(s):Show less -

Alexandra Fleischmann ^[1] ; José M Bertolote ^[2] ; Danuta Wasserman ^[3] ; Diego De Leo ^[4] ; Jafar Bolhari ^[5] ; Neury J Botega ^[6] ; Damani De Silva ^[7] ; Michael Phillips ^[8] ; Lakshmi Vijayakumar ^[9] ; Airi Värnik ^[10] ; Lourens Schlebusch ^[11] ; Huong Tran Thi Thanh ^[12]

Affiliation:Show less -

^[1] World Health Organization. Department of Mental Health and Substance Abuse - Suíça

^[2] World Health Organization. Department of Mental Health and Substance Abuse - Suíça

^[3] Karolinska Institute. Department of Public Health Sciences - Suécia

^[4] Griffith University. Australian Institute for Suicide Research and Prevention - Austrália

^[5] Mental Health Research Centre. Tehran Psychiatric Institute

^[6] UNICAMP. FCM. Department of Psychiatry - Brasil

^[7] University of Colombo. Faculty of Medicine. Department of Psychological Medicine

^[8] Beijing Hui Long Guan Hospital. Beijing Suicide Research and Prevention Center - China

^[9] Department of Psychiatry - Índia

^[10] Estonian Centre of Behavioural and Health Sciences. Estonian-Swedish Mental Health and Suicidology Institute - Estônia

^[11] University of KwaZulu-Natal. Nelson R Mandela School of Medicine. School of Family and Public Health Medicine - África do Sul

^[12] Hanoi Medical University - Vietnã

• Document type: Journal article
• Source: BULLETIN OF THE WORLD HEALTH ORGANIZATION; v. 86, n. 9, p. 703-709, 2008-09-00.

Abstract

OBJECTIVE: To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle-income countries. METHODS: Suicide attempters (n = 1867) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, China) participated, from January 2002 to October 2005, in a randomized controlled trial to receive either treatment as usual, or treatment as usual plus brief intervention and contact (BIC), which included patient education and follow-up. Overall, 91% completed the study. The primary study outcome measurement was death from suicide at 18-month follow-up. FINDINGS: Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group (0.2% versus 2.2%, respectively; χ2 = 13.83, P < 0.001). CONCLUSION: This low-cost brief intervention may be an important part of suicide prevention programmes for underresourced low- and middle-income countries. (AU)