An individual who has attempted suicide requires psychological care. The University Bern Psychiatric Services (UPS) has developed a brief therapy for individuals who have attempted suicide. In a study conducted in collaboration with the London School of Economics and the Department of Emergency Medicine at Inselspital Bern, they have now investigated whether this treatment can also reduce health care costs. The results were published in the renowned JAMA Network journal on 19 October 2018.
Suicide attempts also an economic burden
According to World Health Organisation statistics, roughly one million people worldwide die by suicide every year and about ten times more people attempt suicide. Not only is this an enormous emotional burden for those affected as well as their relatives, it also puts a strain on the health care system – first and foremost, on medical emergency centers and psychiatric clinics. Moreover, attempted suicide is the main risk factor for further suicidal crises. However, the evidence for follow-up treatments reducing the risk of repeated attempts so far is limited.
Doubly effective prevention
The Attempted Suicide Short Intervention (ASSIP), a brief therapy developed in Bern aimed at preventing repeat suicide attempts, was already able to prove an unprecedented efficacy in PLOS Medicine in 2016: it reduced the risk of further suicide attempts by an astonishing 80 percent. As a brief therapy, ASSIP involves only three sessions followed by ongoing contact with the patients by means of regular letters over two years.
The recent study now shows that, together with the reduction of suicide attempts using ASSIP, the costs for emergency treatments and psychiatric hospitalisations are also significantly reduced – the therapy is thus not only clinically effective but also economical. The study comprised 120 patients who had been treated in the Department of Emergency Medicine because of attempted suicide. In addition to the usual psychiatric treatment, half of the patients received three ASSIP sessions followed by personalized letters over two years, whereas the control group was given a single suicide risk assessment. At 24 months of follow-up, 41 repeat suicide attempts were recorded in the control group, compared with only five in the ASSIP group.
With the publication of this study, the Bernese intervention program has a great deal of potential to be implemented in suicide prevention on a global scale. In Switzerland, ASSIP is currently used in Bern, Zurich, Solothurn and Wyss. Internationally, the program has been implemented in Finland, Lithuania, Sweden, Belgium, Austria and the USA, and is planned in, among others, Portugal and Australia.
contact for scientific information:
Dr. phil. Anja Gysin-Maillart, Senior Attending Psychologist for Psychotherapy FSP and Head of ASSIP Consultation
University Bern Psychiatric Services (UPS)
University Hospital of Psychiatry and Psychotherapy anja.gysin-maillart@upd.ch, +41 31 632 88 11.
Prof. Dr. med. Thomas Jörg Müller, Medical Director and Chief Physician
Private Clinic Meiringen, Centre for Mental Well-Being
Translational Research Center, University Bern Psychiatric Services (UPS)
thomas.mueller@privatklinik-meiringen.ch, +41 33 972 82 90.
A-La Park, Assistent Prof. in Health Economics
Personal Social Services Research Unit, Department of Health Policy
London School of Economics and Political Science
A.PARK@LSE.AC.UK
original publication:
doi:10.1001/jamanetworkopen.2018.3680