Postcards in Persia: randomised controlled trial to reduce suicidal behaviours 12 months after hospital-treated self-poisoning

Hossein Hassanian‐Moghaddam · Saeedeh Sarjami · Ali‐Asghar Kolahi · Gregory Leigh Carter

134 citations0/0 files storedThe British Journal of Psychiatry

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Suicide and Self-Harm Studies Poisoning and overdose treatments Opioid Use Disorder Treatment

Abstract

BACKGROUND: Hospital-treated self-poisoning is common, with limited effective interventions for reducing subsequent suicidal behaviour. AIMS: To test the efficacy of a postcard intervention to reduce suicidal behaviour. METHOD: Randomised controlled trial of individuals who self-poisoned (n = 2300), the intervention consisted of nine postcards sent over 12 months versus usual treatment. Outcomes assessed at 12 months (n = 2113) were suicidal ideation, suicide attempts and self-cutting (proportion and event rates). RESULTS: There was a significant reduction in any suicidal ideation (relative risk reduction (RRR) = 0.31, 95% CI 0.22-0.38), any suicide attempt (RRR = 0.42, 95% CI 0.11-0.63) and number of attempts (incidence rate ratios (IRR) = 0.64, 95% CI 0.42-0.97). There was no significant reduction in any self-cutting (RRR = 0.14, 95% CI -0.29 to 0.42) or self-cutting events (IRR = 1.03 95% CI 0.76-1.39). CONCLUSIONS: A postcard intervention reduced suicidal ideation and suicide attempts in a non-Western population. Sustained, brief contact by mail may reduce suicidal ideation and suicide attempts in individuals who self-poison.

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2021Psychosocial interventions for self-harm in adults 2013Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning 2014Assertive case management versus enhanced usual care for people with mental health problems who had attempted suicide and were admitted to hospital emergency departments in Japan (ACTION-J): a multicentre, randomised controlled trial

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