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Research Questions

  1. What is the effect of aftercare interventions on uptake, retention, effectiveness measures, and unintended consequences for individuals who have attempted suicide?
  2. What is the effect of aftercare interventions on uptake, retention, effectiveness measures, and unintended consequences for the family members of people who have attempted suicide?

Following a suicide attempt, components of aftercare can include efforts to reduce suicidal behavior (i.e., suicide, attempt, or ideation) of a person who has attempted suicide and facilitate the psychosocial adjustment of the patient and their family members. The purpose of this systematic review and meta-analysis of key outcomes was to synthesize the existing evidence on interventions for people who have attempted suicide and their family members.

The authors found that aftercare interventions show a statistically significant reduction in further suicide attempts for intervention participants. Studies also reported a reduction in suicide deaths, depression, and hopelessness, but the results are based on limited quality of evidence. The uptake of interventions and treatment retention varied widely by aftercare intervention. The authors could not explore the effects of the intervention target (e.g., participants who attempted suicide versus family members or both) or populations because of the homogeneity of the sample and the lack of studies measuring family member responses. The identified studies did not meaningfully address the effects of interventions on family members because these were rarely included in existing research studies.

Key Findings

  • Interventions showed a statistically significant reduction in further suicide attempts for intervention participants.
  • Studies also reported a reduction in suicide deaths, reduced depression, and reduced hopelessness, but the results were based on limited quality of evidence.
  • Uptake of interventions varied widely by intervention. Similarly, the treatment retention of participants varied considerably.
  • The authors were unable to determine which intervention types systematically produce better outcomes for patients.
  • Research is needed to explore which interventions will produce the greatest clinical improvements and reduction in future suicide attempts and to identify effective interventions for service members and for family members of people who have attempted suicide.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Results

  • Chapter Four

    Discussion

  • Appendix A

    Search Strategy

  • Appendix B

    Evidence Table

  • Appendix C

    Excluded Studies and Background Literature

This research was sponsored by the Psychological Health Center of Excellence and conducted within the Forces and Resources Policy Center of the RAND National Security Research Division (NSRD).

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