Hyun Jo Shin1, Gwan Jin Park2, Yong Nam In1, Sang Chul Kim1, Hoon Kim1, Suk Woo Lee3. 1. Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. 2. Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. Electronic address: pkj83531@naver.com. 3. Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. Electronic address: drrhec@chungbuk.ac.kr.
Abstract
BACKGROUND: A prior suicide attempt is known to be the most important risk factor for suicide. Case management programs provide psychosocial support and rehabilitation for suicide attempters. This study aimed to determine whether case management completion is associated with good clinical outcomes for suicide attempters visiting the emergency department (ED). METHODS: A cross-sectional observational study was conducted using risk assessment records for suicide attempters visiting the ED from October 2013 to December 2017. We created two groups according to completion of the case management program. The primary outcome was a decrease in suicide risk. The secondary and tertiary outcomes were untreated stressors and lack of a support system. We calculated the adjusted odds ratio (AOR) of the case management completion for study outcomes adjusting for potential confounders. RESULTS: Among 439 eligible suicide attempters, only 277 (63.1%) participants completed the case management program. Participants who completed the case management program were more likely to have decreased suicide risk (65.3% vs. 46.9%, AOR: 2.13 (1.42-3.20)) and less untreated stressors (49.8% vs. 61.1%, AOR: 0.64 (0.43-0.96)). However, there was no significant difference in lack of a support system (35.4% vs. 45.7%, AOR: 0.68 (0.45-1.03)). CONCLUSION: Completion of a case management program was associated with reduction of suicide risk. Multicomponent strategies to increase compliance with a case management program are needed to prevent suicide reattempt and reduce the health burden of suicide.
BACKGROUND: A prior suicide attempt is known to be the most important risk factor for suicide. Case management programs provide psychosocial support and rehabilitation for suicide attempters. This study aimed to determine whether case management completion is associated with good clinical outcomes for suicide attempters visiting the emergency department (ED). METHODS: A cross-sectional observational study was conducted using risk assessment records for suicide attempters visiting the ED from October 2013 to December 2017. We created two groups according to completion of the case management program. The primary outcome was a decrease in suicide risk. The secondary and tertiary outcomes were untreated stressors and lack of a support system. We calculated the adjusted odds ratio (AOR) of the case management completion for study outcomes adjusting for potential confounders. RESULTS: Among 439 eligible suicide attempters, only 277 (63.1%) participants completed the case management program. Participants who completed the case management program were more likely to have decreased suicide risk (65.3% vs. 46.9%, AOR: 2.13 (1.42-3.20)) and less untreated stressors (49.8% vs. 61.1%, AOR: 0.64 (0.43-0.96)). However, there was no significant difference in lack of a support system (35.4% vs. 45.7%, AOR: 0.68 (0.45-1.03)). CONCLUSION: Completion of a case management program was associated with reduction of suicide risk. Multicomponent strategies to increase compliance with a case management program are needed to prevent suicide reattempt and reduce the health burden of suicide.
Authors: Christopher M Doran; Lisa Wittenhagen; Edward Heffernan; Carla Meurk Journal: Int J Environ Res Public Health Date: 2021-06-23 Impact factor: 3.390