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Effectiveness of a nationwide aftercare program for suicide attempters

Published online by Cambridge University Press:  23 October 2012

Y.-J. Pan ,
W.-H. Chang ,
M.-B. Lee ,
C.-H. Chen ,
S.-C. Liao  and
E. D. Caine
Y.-J. Pan
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK Department of Psychiatry, Far Eastern Memorial Hospital, Taiwan
W.-H. Chang
Affiliation:
Taiwan Suicide Prevention Center, Department of Health, Taiwan
M.-B. Lee*
Affiliation:
Taiwan Suicide Prevention Center, Department of Health, Taiwan Departments of Psychiatry and Social Medicine, National Taiwan University Hospital and College of Medicine, Taiwan
C.-H. Chen
Affiliation:
Institute of Statistical Science, Academia Sinica and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan
S.-C. Liao
Affiliation:
Taiwan Suicide Prevention Center, Department of Health, Taiwan Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
E. D. Caine
Affiliation:
Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY and VA VISN 2 Center of Excellence for Preventing Suicide, Canandaigua, NY, USA
*
*Address for correspondence: M.-B. Lee, M.D., Departments of Psychiatry and Social Medicine, National Taiwan University Hospital and College of Medicine, No. 7, Chung San South Road, Taipei 100, Taiwan. (Email: [email protected])
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Abstract

Background

The effectiveness of large-scale interventions to prevent suicide among persons who previously attempted suicide remains to be determined. The National Suicide Surveillance System (NSSS), launched in Taiwan in 2006, is a structured nationwide intervention program for people who survived their suicide attempts. This naturalistic study examined its effectiveness using data from the first 3 years of its operation.

Method

Effectiveness of the NSSS aftercare services was examined using a logistic/proportional odds mixture model, with eventual suicide as the outcome of interest. As well, we examined time until death for those who died and factors associated with eventual suicide.

Results

Receipt of aftercare services was associated with reduced risk for subsequent suicide; for service recipients who eventually killed themselves, there was a prolonged duration between the index and fatal attempts. Elderly attempters were particularly prone to a shorter duration between the index and fatal attempts. Male gender, the lethality potential of the index attempt, and a history of having had a mental disorder also were associated with higher risk.

Conclusions

The structured aftercare program of the NSSS appears to decrease suicides and to delay time to death for those who remained susceptible to suicide.

Keywords

Aftercarelethal methodsstructured interventionssuicidesuicide attempts
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1447 - 1454
Copyright
Copyright © Cambridge University Press 2012 

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