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Bliokas VV, Hains AR, Allan JA, Lago L, Sng R. Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial. BMC Public Health 2019; 19:1380. [PMID: 31655571 PMCID: PMC6815378 DOI: 10.1186/s12889-019-7751-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/04/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Suicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed 'aftercare' interventions). METHODS A controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019. DISCUSSION The study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers. TRIAL REGISTRATION ACTRN12618001701213 . Registered on 16 October 2018. Retrospectively registered.
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Affiliation(s)
- Vida V Bliokas
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Northfields Avenue, Wollongong, NSW, 2522, Australia.
| | - Alex R Hains
- Illawarra Health and Medical Research Institute, Northfields Avenue, Wollongong, NSW, 2522, Australia.,Illawarra Shoalhaven Suicide Prevention Collaborative, The Central, Innovation Campus, Wollongong, NSW, 2500, Australia.,Coordinare, Primary Health Network South Eastern NSW, The Central, Innovation Campus, Squires Way, Wollongong, NSW, 2500, Australia
| | - Jonathan A Allan
- University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population, University of Wollongong, Building 234, Innovation Campus, Wollongong, NSW, 2500, Australia
| | - Rebecca Sng
- Grand Pacific Health, 336 Keira Street, Wollongong, NSW, 2500, Australia
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