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Trial shows risk of suicide re-attempt substantially reduced after a novel psychiatric intervention

A low-cost, alliance-based psychiatric intervention for emergency department patients admitted after a suicide attempt substantially reduced suicide re-attempt in a single-site randomized controlled trial published in PLOS Medicine. The trial, conducted by Konrad Michel and colleagues at the University Hospital of Psychiatry, Bern, Switzerland, is the first randomized study of the Attempted Suicide Short Intervention Program (ASSIP), a collaborative patient-therapist intervention for developing and implementing personal safety strategies.

The researchers carried out a randomized clinical trial testing ASSIP in 120 people who had attempted suicide and been admitted to the emergency department of the Bern University General Hospital in Switzerland. The 60 ASSIP participants received three therapy sessions using narrative interviewing and video-playback in order to develop personalized preventive strategies, followed by regular reminders over 24 months. During the 24 months of follow-up, one death by suicide occurred in each group, five repeat suicide attempts were recorded in the ASSIP group, and 41 repeat suicide attempts were recorded in the control group (80% reduced risk of repeat suicide attempt with ASSIP). In addition, ASSIP participants spent 72% fewer days in the hospital during follow-up. There was no difference in patient-reported suicidal ideation or in levels of depression.

Prior successes of interventions to prevent suicide have shown poor generalizability beyond the initial study site; the same challenge may apply here. However, the striking results in Bern suggest that further testing of ASSIP in large clinical trials and diverse settings is warranted.