From ALGOS to VigilanS: New perspectives in nurse skills for suicide prevention

Abstract

There is growing evidence in the literature that brief contact interventions (BCIs) might be reliable suicide prevention strategies. Due to the human and societal burden of suicide in France, French government has supported the assessment of the effectiveness of combining BCIs to reduce suicide at a national level. Nurses play a central role in BCI suicide prevention strategies. To assess the effectiveness of a decision-making algorithm for suicide prevention (ALGOS) combining existing BCIs in reducing suicide reattempts in patients discharged after a suicide attempt. A randomized, multicenter, controlled, parallel trial was conducted in 23 hospitals. The study was conducted from January 26, 2010, to February 28, 2013. People who had made a suicide attempt were randomly assigned to either the intervention group (ALGOS) or the control group. The primary outcome was the rate of participants who reattempted suicide (fatal or not) within the 6-month study period. In total, 1040 patients were recruited. After 6 months, 58 participants in the intervention group (12.8%) reattempted suicide compared with 77 (17.2%) in the control group. We found an absolute reduction in global adverse events outcome (fatal and non fatal suicide reattempt and loss to follow-up) at 6 and 13 months. We are currently replicating the ALGOS experimentation in several French regions with different sociodemographic characteristics under the “VigilanS” project. Nurses play a critical role in such prevention approaches. The effect may also be reinforced by integrating effective TIC systems into work environment. Overall, we believe that the preventative effect of BCIs may be reinforced by integrating these systems into multimodal approaches and long-term follow-up strategies.