Community-Based Case Management for the Prevention of Suicide Reattempts in Kaohsiung, Taiwan

Although a previous suicide attempt constitutes a major risk factor for an eventual completed suicide, few interventions specifically designed to prevent suicide reattempts have been evaluated. The aim of this study was to determine the effectiveness of case management for the prevention of suicide reattempts. A total of 4,765 subjects with a recent suicide attempt referred from medical and non-medical organizations were consecutively recruited from July 2006 to June 2008. The suicide prevention program of Kaohsiung Suicide Prevention Center (KSPC) provided case management and followed up suicide-attempt cases for 6 months. Survival analysis showed that the risk of suicide reattempt was significantly lower in the case management group than in the non-contact group throughout a six-month follow-up period (hazard ratio = 2.93; 95% CI = 2.47-3.47). The hazard ratio (HR) of the Cox proportional hazard model for sex was 0.77 (95% CI = 0.65-0.91). Case management appears to be effective in preventing suicide reattempts in patients with a recent prior attempt. In addition, case management appeared to be more beneficial in preventing suicide reattempts in male subjects.