Preventing suicide in low- to middle-income countries

20 sept 2008--An international study of almost 2,000 people in Brazil, India, Sri Lanka, Iran and China has shown that a low cost strategy to keep in contact with people who have previously attempted suicide, can reduce the risk of subsequent suicides.
Given that suicide is among the top three causes of deaths in 15 to 34-year-olds, the strategy has the potential to help reduce the economic and societal loss of young people in their most productive years of life.
The study, co-authored by the Australian Institute for Suicide Research and Prevention director Professor Diego De Leo, said subsequent suicide deaths reduced from 2.2 per cent in people treated with usual care to 0.2 per cent in the people given extra contact.
The intervention included a one-hour information session about suicidal behaviours, risk factors, constructive coping strategies and referral options.
It also included nine follow-up phone calls or visits by a health professional for 18 months following the patient's discharge from an emergency department.
"Many suicidal patients lack good communication and relationships within their family and with other people," the researchers said.
The intervention not only helped increased the suicide attempters' feelings of connectedness but also increased their skills in solving crises which may otherwise lead to suicidal behaviour.
"Also, systematic follow-up contacts gave the patient a feeling of being seen and heard by someone," they said.
The study, published in the Bulletin of the World Health Organization (WHO), said one of the advantages of the intervention was that it required minimal training or extra resources and was therefore suitable for implementation in low and middle-income countries.
The WHO estimates that about 85 per cent of suicides occur in low and middle-income countries. In 2002, some 877,000 deaths were attributed to suicide.