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Cited by 115Suicide and Self-Harm StudiesPoisoning and overdose treatmentsSubstance Abuse Treatment and Outcomes

Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning.

Open access
Carter, Gregory L., Clover, Kerrie, Whyte, Ian M., Dawson, Andrew H., D'Este, Catherine·2013·British Journal of Psychiatry
DOI 10.1192/bjp.bp.112.112664
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Abstract

Background: Repetition of hospital-treated self-poisoning and admission to psychiatric hospital are both common in individuals who self-poison. Aims: To evaluate efficacy of postcard intervention after 5 years. Method: A randomised controlled trial of individuals who have self-poisoned: postcard intervention (eight in 12 months) plus treatment as usual v. treatment as usual. Our primary outcomes were self-poisoning admissions and psychiatric admissions (proportions and event rates). Results: There was no difference between groups for any repeat-episode self-poisoning admission (intervention group: 24.9%, 95% CI 20.6-29.5; control group: 27.2%, 95% CI 22.8-31.8) but there was a significant reduction in event rates (incidence risk ratio (IRR)=0.54, 95% CI 0.37-0.81), saving 306 bed days. There was no difference for any psychiatric admission (intervention group: 38.1%, 95% CI 33.1-43.2; control group: 35.5%, 95% CI 30.8-40.5) but there was a significant reduction in event rates (IRR=0.66, 95% CI 0.47-0.91), saving 2565 bed days. Conclusions: A postcard intervention halved self-poisoning events and reduced psychiatric admissions by a third after 5 years. Substantial savings occurred in general hospital and psychiatric hospital bed days.

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Crossref · 10.1192/bjp.bp.112.112664

Cites

32 of 32 references verified0 citation errors · 0 not checkable

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  • One psychiatric intervention reduced the number of suicide reattempts simply by sending former patients timely postcards inquiring into their well-being.

    “Indeed, one psychiatric intervention reduced the number of suicide reattempts simply by sending former patients timely postcards inquiring into their well-being (see Carter et al. 2013).”

    From The Psychology of Change: Self-Affirmation and Social Psychological Intervention (2014) · cites this paper as Carter et al. 2013

    The Intervention section describes eight postcards sent during the year after discharge, and the Main findings report about 50% fewer repeat hospital-treated self-poisoning events over five years. But the Results report no significant difference in the proportion of patients who had any repeat episode. The paper measures self-poisoning rather than suicide reattempts specifically, so the claim overstates what was reduced. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • US guidelines recommend offering anticoagulants to patients with atrial fibrillation whose annual risk of stroke exceeds 0.6% to 2%.

    “US guidelines recommend offering anticoagulants to patients with atrial fibrillation whose annual risk of stroke exceeds 0.6% to 2%38,39”

    From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [39]

  • These PPV estimates are in line with risk thresholds used for primary prevention of other similarly impactful conditions.

    “Notably, these PPV estimates are in line with risk thresholds used for primary prevention of other similarly impactful conditions.”

    From Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US (2021) · cites this paper as [39]

  • Specific follow-up strategies shown effective in reducing repeat suicide attempts and/or suicide include caring letters, postcards, crisis cards, and short- or long-term phone or in-person contacts after hospital discharge.

    “Specific follow-up strategies that have been shown to be effective in reducing repeat suicide attempts and/or suicide include the sending of caring letters,81 or postcards,82 crisis cards,83 or short- or long-term phone or in-person contacts after hospital discharge.84,85”

    From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [82]

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1 retracted

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Research works printed but not linked: 1

  1. Guthrie E, Kapur N, Mackway-Jones K, Chew-Graham C, Moorey J, Mendel E, et al. Randomised controlled trial of brief psychological intervention after deliberate self poisoning. BMJ 2001; 323: 135-8.

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Authors
Carter, G. L., Clover, K., Whyte, I. M., Dawson, A. H., & D'Este, C.
Affiliations
  • University of Newcastle Australia (AU)
  • Newcastle University (GB)
  • The University of Sydney (AU)
Corresponding author
Carter, Gregory L.
ORCID
Venue
British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2013-05
Volume
202
Issue
5
Pages
372-380
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.bp.112.112664
OpenAlex
W4322702231
Cited by
115
References
32
Citations by year
2026: 2 · 2025: 7 · 2024: 6 · 2023: 2 · 2022: 4 · 2021: 33 · 2020: 11 · 2019: 8 · 2018: 4 · 2017: 7 · 2016: 15 · 2015: 11 · 2014: 5
FWCI
11.48
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified, 1707 d)
Locations
  • The British Journal of Psychiatry (publishedVersion)
  • NOVA (University of Newcastle Australia) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
self-poisoning, psychiatric hospital admissions, long-term outcomes, cost reduction, hospital bed days, suicide prevention

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