Surveillance is a powerful tool to prevent suicidal acts

Abstract

Is it usefull to keeping under surveillance a suicidal crisis whenever a subject met after a suicide attempt? We advocate an ethic of worriness, keeping the concern of the other, bringing connectedness, etc. But is it effective to keep watch on a suicidal crisis? Several devices have been imagined and tested, although none alone shows a decrease of suicidal behaviors in the general population. Hence, we developped the idea of a simple algorithm (ALGOS) that could combine the qualities of some of the proposed features: a crisis card issued to first attempters, phone call to 15 days for the suicide repeaters, sending a few postcards to uncontactable subjects or diagnosed at risk during the phone call, etc. The ALGOS device is being tested in 23 metropolitan France’s centers, and for now, more than 1000 patients are included in a randomized clinical trial comparing the algorithm effect to a control group of suicide attempters treated as usual (i.e., referred to the general practitioner). This kind of device would be inexpensive to implement and easily generalizable in a territory, can thus bring an important innovation in public health.