Acute suicide prevention: A systematic review of the evidence and implications for clinical practice

Abstract

Objective: Responding appropriately to people in acute distress, including suicidality, is a critical aspect of suicide prevention. Six clinical interventions are used to respond to acute suicidality—pharmacotherapy, Observations, Contracting for Safety, Crisis Response Planning, Safety Planning, and Care • Collaborate • Connect. This study used a systematic review to identify the efficacy of these acute suicide prevention interventions. Method: OvidSP was used to search EMBASE, Emcare, Medline, Ovid Nursing, and PsycINFO from inception to 1 December 2020. The searches combined the terms for suicid* in the title AND observation OR contract*, OR no-suicide OR no-harm OR safe* OR crisis response, OR CRP, OR coping, OR Care Collaborate Connect in the title, abstract, or keywords. Results: Five randomised control trials that evaluated one or more of the five interventions were identified. Interventions evaluated Contracting for Safety, Crisis Response Planning, Safety Planning, and Care • Collaborate • Connect. However, no studies met inclusion criteria. Discussion: Efficacy trials of suicide prevention interventions are urgently needed to ensure those seeking support for suicidality receive timely and effective interventions and to meet this international health priority.