A Randomized Controlled Trial of Post Crisis Suicide Prevention

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Ad Details

  • Ad ID: 121

  • Added: February 29, 2020

  • Views: 898



Statement of the problem

Suicide related deaths in the developed world compose a good proportion in the overall deaths. Surviving suicidal patients having undergone a psycho-therapeutic treatment are often discharged home where a follow up activity on their emotional conditions. These patients have been found to be at high-risk of committing a post suicide thus developing rising concerns on ways to avert the trend and thus deliberate efforts to reduce the rates in this high-risk suicide group. This study seeks to identify whether prolonged feeling of connectedness can be used as a follow up activity means and thus affect high-risk suicide rates downward. The study will use the results obtained, make an inference and compare it with Likeminded School of thoughts in order to determine the best method in combating this situation. The study will establish a follow-up program to suicidal patients for a prospective period managed by research members. The resulting information will be used to determine whether follow up activities can impact high-risk suicide rates.

Research design

The study randomly picked patients in every age bracket and gender both who were willing to be contacted and those who were not willing to be contacted. This ensures that the results obtained have more uniformity considering most persons at a youthful age will have a high tendency of declining help when compared with their older counterparts. Two groups were formed to compare the characteristic they featured towards post suicide crisis; one contact group and the other not contacted group. The groups were further categorized to treatment patients who were still continuing with their psycho-therapeutic sessions, no-treatment patients that had completed psycho-therapeutic sessions but were willing to be contacted and the undersigned group that died before the commencement of the survey. The study was then spread to a spun of five years with the frequency of contact diminished with time so as to allow for the desired results to be achieved. The first one year featured the most frequent visits whereby the high-risk suicidal patients were contacted once in every month for a period of for months and the results representing the death rates for both contacted and un-contacted patients being tabulated. The visits frequency was then reduced to once in every two months for the eight months remaining in the first year and finally a visit after every three months for the remaining four years. The difference in the frequency of visits was gapped further deliberately to identify whether the essence of time and frequency of connectedness was a determinant factor to preventive suicidal measures. At the end of the prospective period, a total of 24 visits had been made with each individual representing contact ranging from 2 to 24 times. Some of the patients declined to engage with the research members in the initial visits but later embarked to participation possibly due to the humble approach of the research methods.


The method adopted in this study is a randomized control trial that is conducted to 3005 post suicidal patients who had been previously interviewed by the group members while at hospital therapy, a month after their discharge. Two groups were created with one been accorded a follow up activity while the other group was not contacted at all and was used as the control group. Vigorous follow up activity was spread to a five year term and inactive ten year extension followed amounting to a 15 year prospective period. Statistics were taken of the dead persons in the first one year, the following four years and eventually the rest ten years. Three different hypotheses were developed to incorporate the different responses got from the victims and their details collected cumulatively. The first hypothesis was based from a school of thought whose view agrees that a person’s sense of isolation would be reduced when the individual’s feeling are interconnected more often and for a from someone having concern about the well being of the suicidal patient. The second hypothesis based its argument on a platform that; for the process to be effective, the intended contact takes initiative from the concerned individuals and must not force itself to the suicidal person while the third hypothesis suggested that a methodical program of parallel nature would put forth a suicide prevention on influence on high-risk persons who refuse assistance of any available means.


The variables displayed in the research was the treatment number (N) which at the beginning of the process was 1939, the contact group where N=389, the no contact group N=454, undermined group N=223 totaling to 3,005 in the 15 prospective years. The no contact group acted as the control variable which was used to stage the characteristic relevance of patients follow up activity. The treatment group N=1,939 was an independent variable since the subsequent behavior of a suicidal case did not necessarily depend on whether the patient accepted contact while still undergoing the psycho-therapy or after finishing the therapeutic sessions. A formal survival analysis was conducted from the date of discharge; each time eliminating persons who died within the time of study of non-suicidal deaths.

Data Collection

The member of the research was able to progressively able to collect the mortality data from California State of Department of Health after the committee on human subjects of the University of California in San Francisco Medical center approved the project. The families of the patients were too helpful in gathering mortality information and the causative agent of death that enabled the research members to classify them accordingly. The authorities were assured that the information obtained was highly confidential and would be solely be used for research purposes only. Furthermore, the identifying information would not be processed while the patient’s identity was concealed with each patient being identified with a random number.

Cultural Consideration

Dealing with emotionally unstable conditions is a fragile condition. This prior knowledge by the research members prompted a more appealing method in reaching out the suicidal patients. The approach method was thus based from the concept played by the role of a feeling of being joined by something meaningful outside oneself which acts as stabilizing force in emotional life. The letters envisaged a brief note with intent to provide human contact that in turn displays a message of hope and acceptance to exert a suicide prevention influence during the contact. Depending on the emotional state of the person, it was identified that different patients exhibited unique potentials in responding to the members, with some patients being harsh and repellant with the move. As matter of fact, 11 out of the 389 patients under the contact group requested the letters to be discontinued while only a mere 25% of the patients in the contact group expressed positive reactions to the letters.

Ethical Considerations

The success of this research was based largely on the patient’s active participation which was most instilled by the ethical approach that ensured patient confidentiality and a modest approach. The research ensured that patients were treated with utmost respect considering the emotional setback they were facing from society repulsion and other breakdowns in life. Although the research had the primary goal of analyzing the effect of contact to suicidal deaths, it encompassed all the others measures that brought the feeling of connectedness and infusion to the patients. As a result, more corporations were realized with some family members joining the project and reentering the health care system with time. It is through ethical considerations that made patients who had declined to accept contact for the first time agreeing to participate in the subsequent letters and commending positively for the post-discharge follow up activities. Indeed, this activity was vowed by some patients as friendlier care than what their families were providing.



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