Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries.
OBJECTIVE
To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle-income countries.


METHODS
Suicide attempters (n = 1867) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, China) participated, from January 2002 to October 2005, in a randomized controlled trial to receive either treatment as usual, or treatment as usual plus brief intervention and contact (BIC), which included patient education and follow-up. Overall, 91% completed the study. The primary study outcome measurement was death from suicide at 18-month follow-up.


RESULTS
Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group (0.2% versus 2.2%, respectively; chi2 = 13.83, P < 0.001).


CONCLUSIONS
This low-cost brief intervention may be an important part of suicide prevention programmes for underresourced low- and middle-income countries.
Fleischmann
Alexandra
A
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. fleischmanna@who.int
Bertolote
José M
JM
Wasserman
Danuta
D
De Leo
Diego
D
Bolhari
Jafar
J
Botega
Neury J
NJ
De Silva
Damani
D
Phillips
Michael
M
Vijayakumar
Lakshmi
L
Värnik
Airi
A
Schlebusch
Lourens
L
Thanh
Huong Tran Thi
HT
D000328:Adult; D001938:Brazil; D002681:China; D005260:Female; D006801:Humans; D007194:India; D007492:Iran; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D011369:Professional-Patient Relations; D012944:Social Support; D013188:Sri Lanka; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology; D055815:Young Adult
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