A Review of Interventions to Reduce the Prevalence of Parasuicide

Katherine Anne Comtois

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Suicide and Self-Harm Studies Psychiatric care and mental health services Personality Disorders and Psychopathology

Abstract

OBJECTIVE: The author reviewed studies of treatments for parasuicide in order to assist health services planners, administrators, and clinicians develop and improve interventions for parasuicide and decrease its prevalence. METHODS: Parasuicide, which is a major risk factor for completed suicide, was defined as any nonfatal self-injury, including suicide attempts and self-mutilation. The literature from 1970 to 2001 was searched using MEDLINE and PsycINFO. Only experimental and quasi-experimental controlled trials of treatment for parasuicidal individuals were selected for review. RESULTS AND CONCLUSIONS: Epidemiological research shows that parasuicide is a prevalent problem afflicting 4 to 5 percent of individuals in the United States. Parasuicide is a significant predictor of completed suicide, which is the ninth leading cause of death in the United States and accounts for 50 percent more deaths than homicide. Although research on treatments for parasuicide is limited, several treatments have received empirical support. Studies of usual care indicate that empirically supported treatments are rarely used and that standard treatments, particularly hospitalization, are very expensive. The author suggests eight practical steps, based on the literature and established health services strategies, for improving services to parasuicidal individuals. These steps are establishing case registries, evaluating the quality of care for parasuicidal persons, evaluating training in empirically supported treatments for parasuicide, ensuring fidelity to treatment models, evaluating treatment outcomes, identifying local programs for evaluation, providing infrastructural supports to treating clinicians, and implementing quality improvement projects.

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References

1993Cognitive-Behavioral Treatment of Borderline Personality Disorder 1999Prevalence of and Risk Factors for Lifetime Suicide Attempts in the National Comorbidity Survey 1991Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients 1999Effectiveness of Partial Hospitalization in the Treatment of Borderline Personality Disorder: A Randomized Controlled Trial 1988A quality of life interview for the chronically mentally ill 2001Treatment of Borderline Personality Disorder With Psychoanalytically Oriented Partial Hospitalization: An 18-Month Follow-Up 1996Attempted suicide in Europe: rates, trend.S and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide 2001Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder

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2005Suicide After Deliberate Self-Harm: A 4-Year Cohort Study 2003Lethality of firearms relative to other suicide methods: a population based study 2017An intervention for nonsuicidal self-injury in young adults: A pilot randomized controlled trial.

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