This level of risk reduction means that for every 100 high-risk adults who received the intervention, five were prevented from attempting suicide in the year after the index ED visit.
The intervention group also had a 15 percent lower relative risk compared with the TAU group for a “broader suicide composite” (attempted or completed suicides, suicide preparatory acts and interrupted or aborted attempts). The screening-only group showed no reduction in risky behavior compared with the TAU group.
Dr. Miller said that despite surprisingly low levels of compliance (only about 61 percent of the intervention group completed one or more of the follow-up calls), “we found significant reductions in future suicidal behavior.”
“The ED-SAFE study is especially timely, given few large-scale efforts to reduce suicide risk in the ED, despite calls from suicide experts and policy makers,” Drs. Jeffrey Bridge and John Campo of Ohio State University in Columbus, and Dr. Lisa Horowitz of the National Institute of Mental Health in Bethesday, Maryland, said in an accompanying editorial.
Besides adding to evidence that targeted efforts to recognize and intervene with individuals at risk for suicide can be life-saving, the study calls attention to “a societal blind spot,” they note. “It is currently normative for EDs in the United States to lack on-site psychiatric services despite the association of mental disorders with 3 leading causes of death: suicide, accidents, and violence,” they wrote.
“This study demonstrates the critical role emergency medicine can play in self-violence prevention,” Dr. Jennifer Wiler, executive vice chair of emergency medicine at the University of Colorado Anschutz Medical Campus in Aurora, told Reuters Health by email. “This was a study of adults, but the rates of suicide are high among teens and should be an area of focus in future studies,” noted Dr. Wiler, who was not involved in the current study.
The study had no commercial funding, and the authors reported no disclosures.