Siam (Suicide Intervention Assisted by Messages): the Development of a Post-acute Crisis Text Messaging Outreach for Suicide Prevention

S.B Berrouiguet,A.Z Alavi,G.V Vaiva,P.C Courtet,E.B.G Baca-Garcia,S.B Brandt,M.W Walter

doi:10.1016/s0924-9338(15)30753-7

Abstract

Introduction Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also acceptable to suicide attempters. Objective The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. Method The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self–harm, from emergency services or after a short hospitalization. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly during 6 month. The text message enquires about the patients’ well-being and includes information regarding individual sources of help and evidence-based self help strategies. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, suicidal behaviour at month 6 and 13 and Medical costs at month 13. Results Results will be accepted regarding the preliminary results of the study. Discussion This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts.

Highlights

Suicidal behaviour and deliberate self-harm are common among adults
The SIAM software that we developed aims to simplify the inclusion of the patients and to have an optimized text sending
As text messages utilize several characteristics of interventions that have significantly reduced the number of suicide reattempts, we propose to assess its efficacy on reducing suicide reattempt in suicide attempters (SAs) population

Summary

Introduction

Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was effective in preventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. The pioneer intervention was proposed by Motto et al [4] and was based on postal contact. They proposed a follow-up in fifteen years after having started the inclusions in 1969. In the year following the suicide attempt, the authors reported a lower number of relapse in the contacted group, especially among women

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