Suicide Prevention by Monitoring and Collaborative Care

The aim of this study is to lower suicide rates in Noord-Brabant with 20% by establishing a chain of care and a suicide prevention system in this regional network of chain partners. To this end, two sub-objectives are (1) to evaluate the effect of the suicide prevention system in terms of completed suicides, non-fatal suicide attempts and patients’ suicidal ideation and (2) to examine the impact of the intervention by the RE-AIM framework and by exploring which factors facilitate or hinder the implementation of the suicide prevention system, or are associated with early withdrawal.

We hypothesize to attain a drop of 20% of completed suicides in Noord-Brabant, the Netherlands.

Entire study: 48 months. Preparatory phase: 18 months. Inclusion phase and follow-up: 24 months. RE-AIM evaluation will overlap with the inclusion phase. Data-analyses, reporting and dissemination 6 months.

The intervention will contain the following elements:

1) Installing a monitoring system with decision aid to support health care professionals in reporting, assessing and monitoring patients at risk for suicide i.e. after a suicide attempt.

2) Providing swift access to persons at risk for suicide in specialist crisis teams of specialty mental health institutions

3) Positioning nurse case-managers in those teams to collaborate with psychiatrists in assessment, case management and treatment of the persons at risk according to the collaborative care model

4) Providing telephone monitoring for a year to the patient, by the nurse case-manager, to enhance adherence to treatment