title: Is Case Management Effective for Long-Lasting Suicide Prevention?
abstract: BACKGROUND
  Case management services have been implemented in suicide prevention programs.
  
  
  OBJECTIVE
  To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan.
  
  
  METHODS
  The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study.
  
  
  RESULTS
  Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established.
  
  
  CONCLUSIONS
  Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Liang-Jen
authors.initials: LJ
authors.lastname: Wang
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Wu
authors.forename: Chih-Ken
authors.initials: CK
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D019090:Case Management; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016728:Self-Injurious Behavior / Q000628:therapy*; D013406:Suicide, Attempted; D013624:Taiwan; D055815:Young Adult; D000092864:Suicide Prevention
keywords: charcoal-burning; home visit; suicide prevention program; survival analysis; telephone contact