If high percentages of patient subjects participated only in a few brief follow

If high percentages of patient subjects participated

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located at all during follow-up.” If high percentages of patient-subjects participated only in a few brief, follow-up contacts, the impressive results may be best explained in large part by the one- hour information session, a type of intervention that could be made available in health care facili- ties around the world. Another limitation is the confirmation of suicide deaths. Official mortality statistics were not available in all sites making it necessary to obtain reports from informants, usually relatives of the deceased. Since tracking down participants proved difficult, tracking down their relatives might prove even harder. Like the interventions used by Motto and Bostrom, those used by the Fleischman-led investiga- tors may be done by specially trained technicians. Highly-skilled clinicians and sophisticated psychotherapeutic interventions may be reserved for individuals that are in a position to receive and to benefit from this form of treatment. BIC treatment costs are modest, making it attractive for translation and implementation in a more universal way. See Table 1, Evidence-based Treatments for the Prevention of Suicide, page 78. Section-at-a-Glance: The world’s scientific literature contains merely two randomized controlled trials that find an effective means to prevent suicide. The interventions used are quite similar: An initial encounter with someone having clinical knowledge and skills in suicidology followed by regular brief follow-up contacts over 18 to 24 months when the interventions were found to be effective. Both studies involve follow-up subsequent to an acute episode of suicidal behaviors. Neither study was designed to partition the relative contribution of the initial encounter from the subsequent contacts. Two conclusions cut across both studies: First, the
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Continuity of Care for Suicide Prevention and Research 64 prevention of suicide appears to require an initial, meaningful clinical discussion about suicide, and, thereafter, a series of short, non-demanding follow-up contacts that demonstrate continued human interest in the individual. Second, suicide prevention interventions that are provided by individual clinicians to individual patients should complement universal strategies that are aimed at large populations. Section-related Recommendations: Please see the last set of Recommendations in Part Six. Evidence-based Treatments that Enhance Follow-up and Continuity of Care for Patients at Risk for Suicide Benefit of outreach services started at or near the time of discharge and sustained thereaf- ter: Immediately after discharge, a member from Welu’s research group “reached out” to every patient-subject to instill greater adherence to the recommended treatment plan. 366 All of these patients were hospitalized after a suicide attempt. As soon as possible after discharge, follow-up contacts started. Most often, these contacts included an initial home visit. Thereafter, weekly or biweekly face-to-face meetings or telephone contacts occurred over a four-month period. These contacts were much more than a mere reminder. At each and every session “motivational therapy”
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