title: Effectiveness of a nationwide aftercare program for suicide attempters.
abstract: BACKGROUND
  The effectiveness of large-scale interventions to prevent suicide among persons who previously attempted suicide remains to be determined. The National Suicide Surveillance System (NSSS), launched in Taiwan in 2006, is a structured nationwide intervention program for people who survived their suicide attempts. This naturalistic study examined its effectiveness using data from the first 3 years of its operation. Method Effectiveness of the NSSS aftercare services was examined using a logistic/proportional odds mixture model, with eventual suicide as the outcome of interest. As well, we examined time until death for those who died and factors associated with eventual suicide.
  
  
  RESULTS
  Receipt of aftercare services was associated with reduced risk for subsequent suicide; for service recipients who eventually killed themselves, there was a prolonged duration between the index and fatal attempts. Elderly attempters were particularly prone to a shorter duration between the index and fatal attempts. Male gender, the lethality potential of the index attempt, and a history of having had a mental disorder also were associated with higher risk.
  
  
  CONCLUSIONS
  The structured aftercare program of the NSSS appears to decrease suicides and to delay time to death for those who remained susceptible to suicide.
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Pan
authors.forename: W-H
authors.initials: WH
authors.lastname: Chang
authors.forename: M-B
authors.initials: MB
authors.lastname: Lee
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: S-C
authors.initials: SC
authors.lastname: Liao
authors.forename: E D
authors.initials: ED
authors.lastname: Caine
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods*; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D013406:Suicide, Attempted; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D000092864:Suicide Prevention