C. Van der Feltz-Cornelis, United Kingdom
University of York Health SciencesPresenter of 3 Presentations
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O305 - Outcomes of a regional suicide prevention systems intervention study: Suicide Prevention by Monitoring and Collaborative Care (SUPREMOCOL) in Noord-Brabant in the Netherlands.
ABSTRACT
Introduction
Since 2007, suicide rates increased in the Netherlands and the province of Noord-Brabant ranked second nationally with a 64% increase. 60% of people who died by suicide did not receive treatment at the time of their death. Gap analysis showed 1) lack of expertise to explore suicide risk in health care or community settings where persons at risk presented; 2) lack of swift access to specialist care addressing suicidality; 3) lack of oversight of the care process and 4) lack of follow up.
Objectives
We developed a regional suicide prevention systems intervention with chain partners at community, general health and mental health care level to address these gaps in Noord-Brabant, aiming at a 20% decrease in the number of suicides.
Methods
The project started October 2016 and lasted 4 years. The intervention has four pillars: 1) Online decision aid for health care professionals to assess suicidal risk and to communicate with chain partners; 2) swift access to care; 3) facilitation of care through the care chain by a dedicated nurse; and 4) 12 months follow up monitoring if the patient still receives appropriate care. We examined the effect of SUPREMOCOL on suicides in a pre-post design.
Results
During the implementation year of the intervention, suicides in Noord-Brabant dropped 17% whereas nationally they dropped 5%, and this effect was sustained after one year.
Conclusions
This suicide prevention systems intervention is effective in reducing suicide rates. Long-term follow-up and implementation is warranted.
W0026 - What Interventions Work for Suicide Prevention? And Do They Work for the Elderly?
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Abstract Body
Background: Suicides occur more often in the young and in the elderly. However, although several studies have been performed to evaluate the effect of suicide prevention in the young, no studies have explored this in the elderly. Somatic comorbidity is associated with elevated suicide risk, especially in case of pain, which occurs often in the elderly.
Objective: To explore if suicide prevention interventions might be applicable in the elderly and if somatic comorbidity might be relevant for their application.
Method: Evidence synthesis of controlled studies evaluating suicide prevention interventions and of collaborative care trials for depressive disorder in patients with and without somatic comorbidity.
Results: Elderly living alone and with multimorbidity are more prone to suicide risk. Hence interventions involving admission in a general hospital after a suicide attempt, short intervention and follow up might be well applicable in the elderly. In terms of outpatient interventions, and IPD analysis found that collaborative care for depressive disorder is effective in reducing suicidality, especially in the elderly. This effect is independent of somatic comorbidity.
Conclusion: There is potential to develop and evaluate suicide prevention interventions for the elderly. Such interventions should address depression, multimorbidity and social isolation and may be provided at general hospital and at outpatient level.