Is Case Management Effective for Long-Lasting Suicide Prevention?
A Community Cohort Study in Northern Taiwan
Abstract
Abstract.Background: Case management services have been implemented in suicide prevention programs. Aims: To investigate whether case management is an effective strategy for reducing the risks of repeated suicide attempts and completed suicides in a city with high suicide rates in northern Taiwan. Method: The Suicide Prevention Center of Keelung City (KSPC) was established in April 2005. Subjects included a consecutive sample of individuals (N = 2,496) registered in KSPC databases between January 1, 2006, and December 31, 2011, with at least one episode of nonfatal self-harm. Subjects were tracked for the duration of the study. Results: Of all the subjects, 1,013 (40.6%) received case management services; 416 (16.7%) had at least one other deliberate self-harm episode and 52 (2.1%) eventually died by suicide. No significant differences were found in the risks of repeated self-harm and completed suicides between suicide survivors who received case management and those who refused the services. However, a significant reduction in suicide rates was found after KSPC was established. Conclusion: Findings suggest that case management services might not reduce the risks of suicide repetition among suicide survivors during long-term follow-up. Future investigation is warranted to determine factors impacting the downward trend of suicide rates.
References
2010). Repetition of suicide attempts: Data from emergency care settings in five culturally different low- and middle-income countries participating in the WHO SUPRE-MISS Study. Crisis, 31, 194-201.
(2012). Media guidelines for the responsible reporting of suicide: A review of effectiveness. Crisis, 33, 190-198.
(2013). Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population. Journal of Affective Disorders, 147, 269-276.
(2002). Telephone contact with patients in the year after a suicide attempt: Does it affect treatment attendance and outcome? A randomised controlled study. European Psychiatry, 17, 82-91.
(2014). Regional changes in charcoal-burning suicide rates in east/southeast Asia from 1995 to 2011: A time trend analysis. PLoS Medicine, 11, e1001622.
(2010). The evolution of the epidemic of charcoal-burning suicide in Taiwan: A spatial and temporal analysis. PLoS Medicine, 7, e1000212.
(2009). A community-based study of case fatality proportion among those who carry out suicide acts. Social Psychiatry and Psychiatric Epidemiology, 44, 1005-1011.
(2012). Community-based case management for the prevention of suicide reattempts in Kaohsiung, Taiwan. Community Mental Health Journal, 48, 786-791.
(2013). Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-Month outcomes of a randomised controlled trial for suicide attempters. BMC Psychiatry, 13, 191.
(2013). The impact of media reporting on the emergence of charcoal burning suicide in Taiwan. PLoS One, 8, e55000.
(2010). Pathways to high-lethality suicide attempts in individuals with borderline personality disorder. Archives of Suicide Research, 14, 342-362.
(2013). The WHO START Study. Crisis, 34, 156-163.
(2008). Lethality of suicide methods. Injury Prevention, 14, 39-45.
(2010). Suicide prevention by limiting access to methods: A review of theory and practice. Social Science and Medicine, 70, 1626-1632.
(2011). Suicide prevention programs through community intervention. Journal of Affective Disorders, 130, 10-16.
(2009). Suicide. Lancet, 373, 1372-1381.
(2009). A randomized controlled multicenter trial of post-suicide attempt case management for the prevention of further attempts in Japan (ACTION-J). BMC Public Health, 9, 364.
(2011). Evaluation of the suicide prevention program in Kaohsiung City, Taiwan, using the CIPP evaluation model. Community Mental Health Journal, 47, 542-550.
(2014). The rate of fatality and demographic characteristics associated with various suicide methods: A community-based study in Northern Taiwan. Crisis, 35, 245-252.
(2010). The leading methods of suicide in Taiwan, 2002-2008. BMC Public Health, 10, 480.
(2008). Suicide mortality trends by sex, age and method in Taiwan, 1971-2005. BMC Public Health, 8, 6.
(2007). Charcoal burning suicides in Hong Kong and urban Taiwan: An illustration of the impact of a novel suicide method on overall regional rates. Journal of Epidemiology and Community Health, 61, 248-253.
(2005). Suicide prevention strategies: A systematic review. JAMA, 294, 2064-2074.
(2011). The effect of national suicide prevention programs on suicide rates in 21 OECD nations. Social Science and Medicine, 73, 1395-1400.
(2004). The epidemiology of case fatality rates for suicide in the northeast. Annals of Emergency Medicine, 43, 723-730.
(2010). Suicide by charcoal burning in Taiwan, 1995-2006. Journal of Affective Disorders, 120, 254-257.
(2006). Media guidelines on the reporting of suicide. Crisis, 27, 82-87.
(1992). Suicide in a community based case management service. Community Mental Health Journal, 28, 483-489.
(2007). Rebuilding the tower of Babel: A revised nomenclature for the study of suicide and suicidal behaviors. Part 2: Suicide-related ideations, communications, and behaviors. Suicide and Life-Threatening Behavior, 37, 264-277.
(2006). Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: Randomised controlled study. British Medical Journal, 332, 1241-1245.
(