Combining postcards, crisis cards, and telephone contact into a decision-making algorithm to reduce suicide reattempt: A randomized clinical trial of a personalized brief contact intervention

Abstract

Background: There is growing evidence in the literature that brief contact interventions (BCIs) might be reliable suicide prevention strategies. Objective: To assess the effectiveness of a decision-making algorithm for suicide prevention (ALGOS) combining existing BCIs in reducing suicide reattempts in patients discharged after a suicide attempt. Methods: A randomized, multicenter, controlled, parallel trial was conducted in 23 hospitals. The study was conducted from January 26, 2010, to February 28, 2013. People who had made a suicide attempt were randomly assigned to either the intervention group (ALGOS) or the control group. The primary outcome was the rate of participants who reattempted suicide (fatal or not) within the 6-month study period. Results: 1,040 patients were recruited. After 6 months, 58 participants in the intervention group (12.8%) reattempted suicide compared with 77 (17.2%) in the control group. The difference between groups (4.4%; 95% CI, -0.7% to 9.0%) was not significant (complete-case analysis, P = .059). Conclusions: These results may help researchers better integrate BCIs into routine health care and provide new insights concerning personalized suicide prevention strategies.