title: Psychosocial interventions following self-harm: systematic review of their efficacy in preventing suicide.
abstract: BACKGROUND
  With almost a million people dying by suicide worldwide each year, reducing the rate of suicidal behaviour is a priority in many countries.
  
  
  OBJECTIVE
  To examine whether additional psychosocial interventions following an episode of self-harm reduce the likelihood of subsequent suicide.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of data from randomised controlled trials of interventions for people following self-harm. Likelihood of suicide was compared by calculating the pooled root difference in suicide rate with 95% confidence intervals.
  
  
  RESULTS
  We obtained suicide data from 18 studies with a total population of 3918. Eighteen suicides occurred among people offered active treatment and 19 among those offered standard care (pooled root difference in suicide rate 0.0,95% CI -0.03 to 0.03). The overall rate of suicide among people participating in trials was similar to that reported in observational studies of people who self-harm.
  
  
  CONCLUSIONS
  Results of this meta-analysis do not provide evidence that additional psychosocial interventions following self-harm have a marked effect on the likelihood of subsequent suicide.
authors.affiliation: Faculty of Medicine, Imperial College London, UK. m.crawford@imperial.ac.uk
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Crawford
authors.forename: Olivia
authors.initials: O
authors.lastname: Thomas
authors.forename: Nusrat
authors.initials: N
authors.lastname: Khan
authors.forename: Elena
authors.initials: E
authors.lastname: Kulinskaya
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D015201:Meta-Analysis as Topic; D011613:Psychotherapy / Q000379:methods*; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention