Effectiveness of brief psychological interventions for suicidal presentations: a systematic review

Abstract

BackgroundEvery year, more than 800,000 people worldwide die by suicide. The aim of this study was to conduct a systematic review of the effectiveness of brief psychological interventions in addressing suicidal thoughts and behaviour in healthcare settings.MethodsFollowing PRISMA guidelines, systematic searches were conducted in MEDLINE, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials and PsycINFO databases. A predefined search strategy was used. Two independent reviewers screened titles and abstracts followed by full texts against predefined inclusion criteria. Backward and forward citation tracking of included papers was conducted. Quality appraisal was conducted using the Cochrane Risk of Bias Tool for Randomized Controlled Trials and the CASP tool for randomised controlled trials. The small number and heterogeneity of studies did not allow for meta-analysis to be conducted. A narrative synthesis was conducted.ResultsFour controlled studies of brief psychological interventions were included, conducted in Switzerland, the U.S. and across low and middle-income countries. Three studies were conducted with adults and one with adolescents. All studies were judged to be at low risk of bias. All of the interventions were implemented with patients after attending emergency departments and involved 3412 participants. The main outcomes were suicide, suicide attempts, suicidal ideation, depression and hospitalization. The components of the interventions were early therapeutic engagement, information provision, safety planning and follow-up contact for at least 12 months. The interventions drew to, different degrees, on psychological theory and techniques. Two trials that measured suicidal ideation found no impact. Two studies showed fewer suicide attempts, one showed fewer suicides and one found an effect on depression.ConclusionsAlthough the evidence base is small, brief psychological interventions appear to be effective in reducing suicide and suicide attempts. All studies to date have been conducted with people who had attended the ED but the interventions could potentially be adopted for inpatient and other outpatient settings. Early engagement and therapeutic intervention based on psychological theories of suicidal behaviour, sustained in follow-up contacts, may be particularly beneficial.Trial registrationSystematic review registration: PROSPERO CRD42015025867.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1663-5) contains supplementary material, which is available to authorized users.

SHORES: A Practical Mnemonic for Suicide Protective Factors

“…Researchers can investigate the SHORES mnemonic by comparing its factors with descriptions from clients who avoided attempting suicide, an approach that is similar to those used in investigating mnemonics for suicide risk factors (Lester, McSwain, & Gunn, ; McGlothlin et al, ). Variables to consider when investigating the utility of SHORES include exploring client results in suicide behavior; in suicidal ideation; and in suicide‐related concerns, such as depression and hopelessness (McCabe, Garside, Backhouse, & Xanthopoulou, ). Clients who received counseling on SHORES can provide their ratings and perspectives on the intervention, including its helpfulness and their own sustained recall of the suicide protective factors (Stanley et al, ).…”

PROTECT: Relational safety based suicide prevention training frameworks

“…Many aspects of ASPIRE are adaptations of well‐established therapeutic approaches. Jobes et al 's () summary of cognitive therapy for suicide prevention, dialectical behaviour therapy, and Collaborative Assessment and Management of Suicidality along with McCabe's () systematic review that identified four brief intervention studies with varied theoretical foundations provides the evidence for these treatments and is the basis for the eclectic approach. ASPIRE includes the cognitive behaviour therapy (Brown et al , )‐based ‘Review Cycle’ which aims to reframe and modulate suicidal triggers, thoughts, feelings, and behaviours.…”

Brief interventions for self-injurious thoughts and behaviors in young people: A systematic review

“…We will conduct searches across electronic databases (PsychINFO, MEDLINE, ERIC, Open Dissertations), and will manually search other relevant manuscripts (du Roscoät & Beck, 2013;Glenn et al, 2015;McCabe et al, 2018;Milner et al, 2015;Schleider et al, 2020;Fox et al, in preparation), for randomized controlled trials conducted in the past 50 years that evaluate effects of brief interventions on self-injurious thoughts and behaviors in young people (January 1, 1970 -January 31, 2020). Search terms will include: child, teen*, adolescen*, youth*, pediatric, college student, college students, young adult, or young adults; and suicid*, self-injury, self-harm, self-mutilation, self-cutting, cutting, self-burning, self-poisoning, NSSI, or SITB; and intervention, prevention, treatment, program, randomized, RCT, workshop, field trial, or training.…”

“…Evidence suggests it is worth taking a closer look at briefer mental health care options for SITBs in young people. For one, there is a clear demand, as calls for briefer SITB interventions are widespread in the suicide literature (Glenn et al, 2015;Lizardi & Stanley, 2010;McCabe et al, 2018;Stanley & Brown, 2012;Stewart et al, 2019). Further, brief interventions have shown promise for treating psychiatric problems in youth.…”

“…interventions for depression); therefore, brief interventions designed to target related outcomes with potential effects for SITBs were not included. Additionally, the authors excluded treatments for NSSI (McCabe et al, 2018). A second review focused on brief contact interventions, but these interventions by definition involve "light touch" intervention that takes place over an extended period of time (e.g.…”