Citation

Fossi Djembi L, Vaiva G, Debien C, Duhem S, Demarty AL, Koudou YA, Messiah A. BMC Psychiatry 2020; 20(1): e26.

Affiliation

INSERM Research unit U-1178 "Mental Health and Public Health", Centre de recherche en Epidémiologie et santé des populations (CESP), INSERM, Université Paris-Sud, Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12888-020-2443-6

PMID

31992251

Abstract

BACKGROUND: Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center.

METHODS: The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS' penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed.

RESULTS: Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = - 1.13; p = 3*10^- 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%.

CONCLUSION: VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.

Language: en

Keywords

Brief contact interventions; Evaluation; Prevention; Suicide attempts