Fewer suicide attempts after talk therapy

"Now we have evidence that psychosocial treatment—which provides support, not medication—is able to prevent suicide in a group at high risk of dying by suicide," says Annette Erlangsen. (Credit: Mao Carrera/Flickr)

People who attempt suicide then undergo counseling are less likely to try again. In fact, short-term counseling after a failed suicide cut repeat attempts and deaths by roughly a quarter.

Patients who voluntarily took part in just six to 10 talk therapy sessions saw long-term benefits: five years after counseling ended, there were 26 percent fewer suicides among those who received treatment compared with those who did not.

“We know that people who have attempted suicide are a high-risk population and that we need to help them. However, we did not know what would be effective in terms of treatment,” says Annette Erlangsen, adjunct associate professor of mental health at Johns Hopkins University’s Bloomberg School of Public Health.

“Now we have evidence that psychosocial treatment—which provides support, not medication—is able to prevent suicide in a group at high risk of dying by suicide.”

Fewer suicide attempts

In Denmark, which has free health care for its citizens, the first suicide prevention clinics were opened in 1992 for people at risk of suicide but not in need of psychiatric hospitalization. Clinics were opened nationwide in 2007.


The researchers analyzed health data from Danes who attempted suicide from 1992 to 2010. They looked at 5,678 people who received psychosocial therapy at one of eight suicide prevention clinics.

They then compared their outcomes over time with those of 17,304 people who looked similar on 31 factors but had not gone for treatment after attempting to kill themselves. Participants were followed for up to 20 years.

During the first year, those who received therapy were 27 percent less likely to attempt suicide again and 38 percent less likely to die of any cause.

After five years, there were 26 percent fewer suicides in the group that had been treated following their attempt. After 10 years, the suicide rate for those who had therapy was 229 per 100,000 compared to 314 per 100,000 in the group that did not get the treatment.

What’s the ‘active ingredient’?

The therapy itself varied depending on the patient so the researchers can’t say exactly what “active ingredient” inoculated many against future suicide attempts.

They say it’s possible that it was simply having a safe, confidential place to talk, but plan to look at more data to see if specific types of therapy worked better than others.

It has not previously been possible to determine if a specific suicide prevention treatment was working, says Elizabeth A. Stuart, associate professor of mental health and a coauthor of the study.

It would be unethical to do a randomized study in which some subjects get prevention therapy and others don’t. That the Danish clinics were rolled out over 15 years and participation was voluntary, and that extensive baseline and long-term follow-up data were available, gave researchers a way to analyze therapy effectiveness.

“Our findings provide a solid basis for recommending that this type of therapy be considered for populations at risk for suicide,” she says.

The Danish Health Insurance Foundation and Danish government sources funded Stuart’s participation was supported in part by the US National Institute of Mental Health. The results appear in the journal Lancet Psychiatry.

Source: Johns Hopkins University