The Huey team contended with a more challenged population and used an

The huey team contended with a more challenged

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The Huey team contended with a more challenged population and used an immediately available intensive intervention to achieve significant reductions over time in suicide ideation and attempt behavior. The two interventions used were designed specifically for the target populations, sug- gesting strongly that more specialized, anti-suicide psychological therapies may be more effective compared to more generic, usual-care therapies. These studies suggest that intensive treatment starting immediately after the initial request for help may be substituted for hospitalization. Possible added benefits from getting to know the therapist during the ED visit: There is every reason to believe that continuity of providers improves outcomes. This feature coupled with in- tensity of therapy characterized an inquiry from Canada commenced by Termansen and Bywater in 1975. 388 Termansen and Bywater’s study recruited ED patients making a suicide attempt of any sever- ity. Intervention began at or close to the time of the patient’s ED experience. Experienced mental health workers gave the intensive treatment. Sessions were daily for the first week and every two days for two weeks; frequency was down-tapered slowly over the research’s 12-week duration. At three months the reattempt rate associated with the highest intensity of treatment was 2 percent, which is significantly different from 6 percent associated with the next level of intensity. One limi- tation was the highly variable severity of the index suicide attempt. These investigators remark that only 45 percent of ED discharges were given any sort of follow-up. Similar continuity of care procedures and intensity of treatment characterized the Huey-lead in- vestigation reviewed just above. 245 Please refer to that description for the favorable results associ- ated with that investigation. An inquiry by van der Sande found that an intensive intervention beginning right after the initial examination failed to decrease suicide reattempts, but it did increase participation in outpatient treatment significantly. 246 Suicide attempters, 15 years and older, presenting to a hospital for treat- ment were randomly assigned to either a four-bed specialty unit with a maximum four-day length
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Continuity of Care for Suicide Prevention and Research 72 of stay or assigned to treatment as usual. Short-stay patients were able to follow-up with a nurse that worked in the short-stay unit; presumably, patients got to know their assigned nurses. De- scriptions of the treatment seem somewhat generic. “Patients were encouraged to talk about their problems” is mentioned as one example of the therapy’s content. While there were no group dif- ferences in suicide-reattempt behaviors, 89 percent of the experimental group (versus 55 percent for usual care) from the short-stay unit attended one or more outpatient sessions. The experimental group attended, on average, three more sessions—a significant result.
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