Outcomes of a two-tiered multifaceted elderly suicide prevention program in a Hong Kong Chinese community.
OBJECTIVE
1) To compare the 2-year completed suicide and reattempt rates in a preintervention group of Hong Kong Chinese suicide attempters (aged 65 years and older) who received standard care and a postintervention group enrolled in a regional elderly suicide prevention program (ESPP) that adopts a two-tiered multifaceted care management model and 2) to examine the trend of suicide rates in older adults aged 65 years and older in the pre- and postintervention periods.


METHODS
The first part is an observational cohort study with baseline, follow-up, and outcome data being identified from a clinical electronic registry. The second part examines changes in suicide rates from official mortality statistics.


METHODS
A government-funded suicide intervention program serving catchment population (852,796 people aged 65 years and older) in Hong Kong, China.


METHODS
Suicide attempters (aged 65 years and older) presenting to old-age psychiatric service in the pre- and postintervention phases.


METHODS
1) Two-year rates of completed suicide and suicide reattempt and 2) changes in population suicide rates in the pre- and postintervention periods.


RESULTS
The 2-year completed suicide rate was 7.58% in the preintervention group (N = 66) and 1.99$% in the ESPP group (N = 351) Χ = 6.192; p value: 0.028; df = 1). Reattempt rates were not different. At a population level, suicide rate dropped significantly only in women aged 85 years and older, relative to the preintervention period.


CONCLUSIONS
The ESPP was associated with a reduced rate of completed suicide in old-age suicide attempters and might have contributed to a fall of suicide rate in women aged 85 years and older.
Chan
Sandra S
SS
Department of Psychiatry, The Chinese University of Hong Kong. schan@cuhk.edu.hk
Leung
Vivian P Y
VP
Tsoh
Joshua
J
Li
S W
SW
Yu
C S
CS
Yu
Gabriel K K
GK
Poon
T K
TK
Pan
P C
PC
Chan
W F
WF
Conwell
Yeates
Y
Lam
Linda C W
LC
Chiu
Helen F K
HF
D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D003156:Community Mental Health Services; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D016012:Poisson Distribution; D015397:Program Evaluation; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control / Q000706:statistics & numerical data; D000092864:Suicide Prevention
Psychiatr Serv. 2001 Jun;52(6):828-33
11376235
Int J Geriatr Psychiatry. 2006 Feb;21(2):113-8
16416469
Aust N Z J Ment Health Nurs. 1999 Jun;8(2):65-73
10661074
Psychol Med. 2003 Apr;33(3):395-405
12701661
JAMA. 2004 Mar 3;291(9):1081-91
14996777
Am J Geriatr Psychiatry. 2005 Jul;13(7):562-71
16009732
Acta Psychiatr Scand. 2006 Sep;114(3):159-67
16889586
Arch Gen Psychiatry. 2007 Aug;64(8):914-20
17679636
Acta Psychiatr Scand. 2004 Apr;109(4):299-305
15008804
BMJ. 2005 Oct 8;331(7520):805
16183654
Psychiatry Clin Neurosci. 2005 Jun;59(3):337-44
15896228
Acta Psychiatr Scand. 1989 Aug;80(2):151-4
2801163
Suicide Life Threat Behav. 2001 Spring;31 Suppl:32-47
11326758
Suicide Life Threat Behav. 2000 Spring;30(1):61-73
10782719
Br J Psychiatry. 1974 Oct;125(0):355-73
4425774
JAMA. 2005 Jan 19;293(3):311-9
15657324
J Affect Disord. 2007 Sep;102(1-3):1-9
17223200
JAMA. 2005 Oct 26;294(16):2064-74
16249421
Br J Psychiatry. 2002 Sep;181:226-9
12204927
Br J Psychiatry. 1993 Jul;163:111-2
8353677
J Psychiatr Res. 1982-1983;17(1):37-49
7183759
Psychol Med. 2000 Jul;30(4):813-21
11037089
Gen Hosp Psychiatry. 1996 Nov;18(6):444-7
8937913
Eur Psychiatry. 2002 Apr;17(2):82-91
11973116
Suicide Life Threat Behav. 1992 Fall;22(3):303-14
1440744
Int J Geriatr Psychiatry. 2008 Dec;23(12):1231-8
18500689
BMJ. 2003 May 10;326(7397):1008
12742921
J Affect Disord. 2001 Jan;62(1-2):123-9
11172879
Med J Aust. 2001 Mar 5;174(5):222-6
11280692
Seishin Shinkeigaku Zasshi. 1998;100(7):469-85
9778997
MMWR CDC Surveill Summ. 1999 Dec 17;48(8):27-50
10634270