Background: Suicide is a major public health problem. Those attempting suicide have a high risk to reattempt again in the future. Few methods have been found that significantly reduce the repetition of suicidal behavior. This review examines current evidence to see if telephone interventions after discharge might reduce the rate of reattempts.
Methods: An exhaustive search of available literature was performed in June 2017 using MEDLINE-PubMed, Web of Science, and CINAHL. Keywords used included: suicide attempts, telephone, and emergency departments. The search results were narrowed to include only English-language articles, human studies, randomized controlled trials, and studies conducted between June 2005 and June 2017. Studies were screened to include only patients 16 years and older who presented to the ED after a suicide attempt, and ones which involved post care telephone-based interventions. The quality of relevant articles was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).
Results: A total of 30 articles were discovered and subsequently screened according to inclusion criteria. The result was a total of three randomized control trials. One RCT found that telephone contact 1 month after ED discharge may help reduce instances of reattempted suicides over 1 year. Another RCT found no significant difference in number of suicide attempts after intervention. The third RCT determined that the effect of telephone intervention could not be confirmed due to high dropout rates.
Conclusion: The data is inconsistent as to the effect of telephone interventions for this group of patients. Still there was some data that showed benefits. Considering the dire consequences of suicidality combined with what may potentially be a relatively easy intervention to implement, considerations to change the current standard of care may therefore be warranted. Without doubt more studies are needed to obtain stronger evidence as to whether it is effective or ineffective. Preferable study methods would be randomized controlled trials that all involve the exact same parameters for the intervention itself.
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