Benefits of a Secondary Prevention Program in Suicide

Abstract

Background: The effectiveness of suicide intervention programs has not been assessed with experimental designs.

Aim: To determine the risk of suicide reattempts in patients engaged in a secondary prevention program.

Method: We included 154 patients with suicidal behavior in a quasi-experimental study with a nontreatment concurrent control group. In all, 77 patients with suicidal behavior underwent the Suicide Behavior Prevention Program (SBPP), which includes specialized early assistance during a period of 3-6 months. A matched sample of patients with suicidal behavior (n = 77) was selected without undergoing any specific suicide prevention program. Data on sociodemographics, clinical characteristics, and suicidal behavior were collected at baseline (before SBPP) and at 12 months.

Results: After 12 months, SBPP patients showed a 67% lower relative risk of reattempt (χ² = 11.75, p = .001, RR = 0.33 95% CI = 0.17-0.66). Cox proportional hazards models revealed that patients under SBPP made a new suicidal attempt significantly much later than control patients did (Cox regression = 0.293, 95% CI = 0.138-0.624, p = .001). The effect was even stronger among first attempters.

Limitations: Sampling was naturalistic and patients were not randomized.

Conclusion: The SBPP was effective in delaying and preventing suicide reattempts at least within the first year after the suicide behavior. In light of our results, implementation of suicide prevention programs is strongly advisable.

Keywords: reattempt; secondary prevention program; suicidal behavior.