SIAM (Suicide intervention assisted by messages): The development of a post-acute crisis text messaging outreach for suicide prevention

Abstract

Background: Suicidal behaviour and deliberate self-harm are common among adults. Research indicates thatmaintaining contact either via letter or postcard with at-risk adults following discharge from care services canreduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also effective inpreventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effectof text message intervention versus traditional treatment on reducing the risk of suicide attempt repetitionamong adults after self-harm.Methods/design: The study will be a 2-year multicentric randomized controlled trial conducted by the BrestUniversity Hospital, France. Participants will be adults discharged after self-harm, from emergency services or aftera short hospitalization. Participants will be recruited over a 12-month period. The intervention is comprised of anSMS that will be sent at h48, D7, D15 and monthly. The text message enquires about the patients' well-being andincludes information regarding individual sources of help and evidence-based self help strategies. Participants willbe assessed at the baseline, month 6 and 13. As primary endpoint, we will assess the number of patients whoreattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients whoreattempt suicide at 13 month, the number of suicide attempts in the intervention and control groups at 6 and13 month, the number of death by suicide in the intervention and control groups at month 6 and 13. In bothgroups, suicidal ideations, will be assessed at the baseline, month 6 and 13. Medical costs and satisfaction will beassessed at month 13.Discussion: This paper describes the design and deployment of a trial SIAM; an easily reproducible interventionthat aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that haveshown a significant reduction in the number of suicide reattempts. We propose to assess its efficacy in reducingsuicide reattempt in the suicide attempter (SA) population.Trial registration: The study was registered on Clinical Trials Registry (clinicaltrials.gov): NCT02106949, registrerdon 06 June 2014.