Citation

Milner AJ, Carter G, Pirkis J, Robinson J, Spittal MJ. Br. J. Psychiatry 2015; 206(3): 184-190.

Affiliation

Allison J. Milner, BPsych (Hons), MEpi, PhD, McCaughey VicHealth Centre for Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Greg Carter, MBBS, FRANZCP, Cert Child Psych, PhD, Centre for Translational Neuroscience and Mental Health, Faculty of Health and Medicine, University of Newcastle, Callaghan; Jane Pirkis, BA (Hons), MPsych, MAppEpid, PhD, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Jo Robinson, BSc (Hons) Master Psych, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Melbourne; Matthew J. Spittal, BSc (Hons), MBio, PhD, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.

Copyright

(Copyright © 2015, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.114.147819

PMID

25733570

Abstract

Background There is growing interest in brief contact interventions for self-harm and suicide attempt. Aims To synthesise the evidence regarding the effectiveness of brief contact interventions for reducing self-harm, suicide attempt and suicide.

METHOD A systematic review and random-effects meta-analyses were conducted of randomised controlled trials using brief contact interventions (telephone contacts; emergency or crisis cards; and postcard or letter contacts). Several sensitivity analyses were conducted to examine study quality and subgroup effects.

RESULTS We found 14 eligible studies overall, of which 12 were amenable to meta-analyses. For any subsequent episode of self-harm or suicide attempt, there was a non-significant reduction in the overall pooled odds ratio (OR) of 0.87 (95% CI 0.74-1.04, P = 0119) for intervention compared with control. The number of repetitions per person was significantly reduced in intervention v. control (incidence rate ratio IRR = 066, 95% CI 0.54-0.80, P<0001). There was no significant reduction in the odds of suicide in intervention compared with control (OR = 0.58, 95% CI 0.24-1.38).

CONCLUSIONS A non-significant positive effect on repeated self-harm, suicide attempt and suicide and a significant effect on the number of episodes of repeated self-harm or suicide attempts per person (based on only three studies) means that brief contact interventions cannot yet be recommended for widespread clinical implementation. We recommend further assessment of possible benefits in well-designed trials in clinical populations.

Language: en