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Brief health care interventions may help lower suicide rates, study finds

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ByDr. Yalda Safai
June 26, 2020, 9:04 AM

When it comes to suicide prevention, even a little bit of help can go a long way.

That's according to a recent study, published in Jama Psychiatry, which found that brief encounters with a health care professional may lower a person's risk of attempting suicide for up to a year.

The study examined more than 4,000 suicidal patients, and found that short, in-person encounters with health care workers made a large difference in reducing suicide risk. Patients who had these brief encounters were more likely to seek additional help and more likely to commit to ongoing outpatient mental health care.

Over the past decade, the rate of suicide has been increasing in the United States, according to the Centers for Disease Control and Prevention, which has called for more urgently addressing the issue.

Previous studies have shown that among people who attempt suicide, about 40% made a health care visit within the week before their attempt and about 95% within the preceding year, with some variation among persons of different races or ethnicities.

PHOTO: In this undated stock photo, a patient has a discussion with her doctor.
STOCK PHOTO/Getty Images

While psychiatric emergency rooms are well-equipped to treat patients in distress, other health care settings -- urgent care centers, clinics, medical emergency rooms, and even jails and shelters -- are less so.

"Most urgent care and primary care settings do not have any protocols on what to do with suicidal patients," Dr. Mona Degan, a primary care physician working in an urgent care setting in Los Angeles, told ABC News.

Dr. Shailinder Singh, a psychiatric emergency room physician in New York City, added: "For many people, these clinics or urgent care centers are their first, and often only, contact with a physician."

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Singh said implementing interventions at this level could identify depressive symptoms early and significantly help reduce immediate and future suicide risk.

The study's authors identified four important components to a successful program that can be implemented fairly easily at urgent care clinics, emergency rooms, jails and shelters:

  • Hiring a dedicated mental health professional
  • Following up with patients via phone calls and letters
  • Creating a plan to cope with situations in which the patient become a danger to themselves or others
  • Encouraging additional ongoing mental health treatment, such as therapy
  • When the four components are used successfully, the study's authors predict it could help decrease the rate of suicide. The authors also suggested that motivational interviewing of patients and helping them with problem-solving skills could help.

    Brief interventions can be delivered in a single, time-limited encounter by a trained professional, who always should emphasize the need for ongoing treatment. Ideally, such interactions would be followed up with a phone call or a friendly letter telling the patient others care about their well-being.

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    "Private care settings and community clinics outside the realm of psychiatry can help by having resources about local psychiatric clinics available to provide to patients, and can incorporate depression screenings into their routine exams," Singh said.

    Effective suicide prevention strategies require many different types of professionals working together, because the underlying drivers of suicide include psychological, biological, and societal factors and "suicide mitigation or prevention cannot be achieved through a single modality," Singh added. "It requires multiple interventions all working together."

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    The authors of this study took into account the multidisciplinary approach to preventing suicide when deciding which interventions to recommend.

    "It is essential," Degan said, "to have a set protocol or guidelines for the management of suicidal patients in an urgent care setting."

    Doing so, Degan added, can save lives.

    Yalda Safai, M.D., M.P.H., is a psychiatrist resident in New York City and a contributor to the ABC News Medical Unit.

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