Checking in: Interventions like follow-up phone calls reduce suicide rates, study finds

AURORA, Colo. — Feeling suicidal is like a silent storm: the lightening is strong, but nobody can hear it happening. Often times, it is loneliness that leads to thoughts of ending one’s own life. Now recent research finds that preventing such feelings through interventions like follow-up phone calls to suicidal patients have the potential to reduce future suicide attempts by 30 percent.

Researchers at the University of Colorado Anschutz Medical Campus and Brown University conducted a year-long trial with nearly 1,400 suicidal patients in eight Emergency Department (ED) locations nationwide. As the tenth most common reason of death in the U.S., more than one million people try to permanently solve a temporary problem by attempting to take their own life.

The authors sought to focus on patients’ well-being and responses to several intervention techniques: specialized screening, safety planning guidance and follow-up phone calls.

Photo of sad girl
A new study finds that checking in with a suicidal person via interventions like follow-up phone calls can prevent suicide attempts by as much as 30%.

“People who are suicidal are often disconnected and socially isolated,” says study co-author Dr. Dr. Michael Allen, a professor of psychiatry and emergency medicine at CU Anschutz, in a news release. “So any positive contact with the world can make them feel better.”

Led by Ivan Miller, a psychologist at Brown as well as Butler Hospital in Providence, the trial was split into three phases. In phase one, 497 patients acted as the control group and received each ED’s usual treatment. In phase two, 377 patients received ED universal screening. In the third phase, 502 patients had the experimental intervention.

All of the patients received follow-up phone calls from trained providers at Butler Hospital. The clinicians discussed suicide risk factors, personal values and goals, safety and future planning, treatment engagement and problem solving with the patients.

Compared to the usual ED treatment, the number of suicide attempts in the patients who received more intervention reduced significantly.

Meanwhile, the second phase of patients, who only received additional universal screening did not show much difference compared to the usual treatment group.

Miller noted that while interventions like phone calls are well-known, it is rare to see any published controlled trials on the effects of certain interventions.

“We were happy that we were able to find these results,” says Miller in a university press release.

Allen, who is also the medical director of Rocky Mountain Crisis Partners in Denver, says that the typical scenario of a suicidal patient being discharged from an ED with a psychiatric referral isn’t enough. At his facility, he has executed a program with the same idea: counselors call suicidal patients to check on them up to seven times following their discharge from EDs.

It is important to note that Colorado, where the study took place, records about 1,000 suicides a year, making it one of the top 10 states for suicide. Colorado’s state legislature is aiming to reduce suicides by 20 percent by 2024.

“Telephone follow-up programs offer a great way to help bridge an ED visit to outpatient mental health care and hopefully save lives,” says study collaborator and associate professor of emergency medicine at CU Anschutz, Dr. Emmy Betz. “It would be great to see such programs become more widely implemented. Suicide is a leading cause of death, especially in Colorado, and a shortage of inpatient and outpatient mental health care options make innovative approaches like telephone counseling even more attractive.”

You never know how much a phone call can mean to someone, until you pick up the phone.

The full study was published in the June issue of the journal JAMA Psychiatry.

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