Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

• Main Authors: Min-Hyuk Kim, Jinhee Lee, Hyunjean Noh, Jin-Pyo Hong, Hyun Kim, Yong Sung Cha, Joung-Sook Ahn, Sei-Jin Chang, Seongho Min
• Format: Article
• Language: English
• Published: MDPI AG 2020-04-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: suicide; suicide attempts; intervention; case management
• Online Access: https://www.mdpi.com/1660-4601/17/7/2599
• ISSN: 1661-7827; 1660-4601

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13–0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09–0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts.