Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide.

Milner, Allison J.; Carter, Greg; Pirkis, Jane; Robinson, Jo; Spittal, Matthew J.

doi:10.1192/bjp.bp.114.147819

Cited by 211Suicide and Self-Harm StudiesMental Health Treatment and AccessPsychiatric care and mental health services

Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide.

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Milner, Allison J., Carter, Greg, Pirkis, Jane, Robinson, Jo, Spittal, Matthew J.·2015·British Journal of Psychiatry

DOI 10.1192/bjp.bp.114.147819

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Abstract

BACKGROUND: There is growing interest in brief contact interventions for self-harm and suicide attempt. AIMS: To synthesise the evidence regarding the effectiveness of brief contact interventions for reducing self-harm, suicide attempt and suicide. METHOD: A systematic review and random-effects meta-analyses were conducted of randomised controlled trials using brief contact interventions (telephone contacts; emergency or crisis cards; and postcard or letter contacts). Several sensitivity analyses were conducted to examine study quality and subgroup effects. RESULTS: We found 14 eligible studies overall, of which 12 were amenable to meta-analyses. For any subsequent episode of self-harm or suicide attempt, there was a non-significant reduction in the overall pooled odds ratio (OR) of 0.87 (95% CI 0.74-1.04, P = 0119) for intervention compared with control. The number of repetitions per person was significantly reduced in intervention v. control (incidence rate ratio IRR = 066, 95% CI 0.54-0.80, P<0001). There was no significant reduction in the odds of suicide in intervention compared with control (OR = 0.58, 95% CI 0.24-1.38). CONCLUSIONS: A non-significant positive effect on repeated self-harm, suicide attempt and suicide and a significant effect on the number of episodes of repeated self-harm or suicide attempts per person (based on only three studies) means that brief contact interventions cannot yet be recommended for widespread clinical implementation. We recommend further assessment of possible benefits in well-designed trials in clinical populations.

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National best practices for suicide prevention recommend that people identified as at risk receive treatment aimed at lowering suicide risk and services that keep them engaged in mental health care.
“National suicide prevention best practices recommend that individuals identified as being at risk of suicide receive treatment specifically directed to reduce their risk of suicide and services to ensure they remain engaged in mental health care.6”
From Association of Suicide Prevention Interventions With Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings: A Systematic Review and Meta-analysis (2020) · cites this paper as [6]
Follow-up interventions are typically brief (6-12 sessions), low cost, nondemand interventions that can be conducted by anyone and occur on a structured schedule over a designated period.
“In contrast to other resource intensive suicide-specific interventions that require a mental health specialist, follow-up interventions are typically brief (6-12 sessions), low cost, nondemand interventions that can be conducted by anyone and occur according to a structured schedule over a designated period (e.g., 1 year).77,78”
From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [77]

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Grenyer, B. F. S., Lewis, K. L., Fanaian, M., & Kotzé, B. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206472 · Cited by 71 · see citing works
Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression
Hetrick, S. E., Robinson, J., Spittal, M. J., & Carter, G. L. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011024 · Cited by 71 · see citing works
Suicide Risk Assessment
Carter, G. L., & Spittal, M. J. (2018) · Crisis · doi:10.1027/0227-5910/a000558 · Cited by 67 · see citing works
Accuracy requirements for cost-effective suicide risk prediction among primary care patients in the US
Ross, E. L., Zuromski, K. L., Reis, B. Y., Nock, M. K., Kessler, R. C., & Smoller, J. W. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0089 · Cited by 65 · see citing works
Screening and Intervention for Suicide Prevention: A Cost-Effectiveness Analysis of the ED-SAFE Interventions
Dunlap, L. J., Orme, S., Zarkin, G. A., Arias, S. A., Miller, I. W., Camargo, C. A., Sullivan, A. F., Allen, M. H., Goldstein, A. B., Manton, A. P., et al. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201800445 · Cited by 61 · see citing works
Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015
Wang, R., Bishwajit, G., Zhou, Y., Wu, X. L., Feng, D., Tang, S., Chen, Z., SHAW, I. F., Wu, T., Song, H., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0221430 · Cited by 60 · see citing works
Methods and Efficacy of Social Support Interventions in Preventing Suicide: A Systematic Review and Meta-Analysis
Hou, X., Wang, J., Guo, J., Zhang, X., Liu, J., Qi, L., & Zhou, L. (2020) · Evidence-Based Mental Health · doi:10.1136/ebmental-2021-300318 · Cited by 62 · see citing works
Mechanisms of brief contact interventions in clinical populations: a systematic review
Milner, A. J., Spittal, M. J., Kapur, N., Witt, K., Pirkis, J., & Carter, G. L. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0896-4 · Cited by 58 · see citing works
Suicide prevention and follow-up services: A narrative review
Ghanbari, B., Malakouti, S. K., Nojomi, M., Alavi, K., & Khaleghparast, S. (2015) · Global Journal of Health Science · doi:10.5539/gjhs.v8n5p145 · Cited by 55 · see citing works
Cognitive behavioral therapy for suicide prevention in youth admitted to hospital following an episode of self-harm: A pilot randomized controlled trial
Sinyor, M., Williams, M., Mitchell, R. H. B., Zaheer, R., Bryan, C. J., Schaffer, A., Westreich, N., Ellis, J., Goldstein, B. I., Cheung, A., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.178 · Cited by 54 · see citing works
Rural-urban and gender differences in the association between community care services and elderly individuals’ mental health: a case from Shaanxi Province, China
Liu, Y., Wang, L., & Dai, X. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06113-z · Cited by 52 · see citing works
“However, it is difficult to adequately address older adults’ mental health problems due to the limited professional medical resources [11].”
Background
Efficacy of the Zero Suicide framework in reducing recurrent suicide attempts: cross-sectional and time-to-recurrent-event analyses
Stapelberg, N. J. C., Svetičič, J., Hughes, I. P., Almeida‐Crasto, A., Gaee-Atefi, T., Gill, N. S., Grice, D., Krishnaiah, R., Lindsay, L., Patist, C., et al. (2020) · The British Journal of Psychiatry · doi:10.1192/bjp.2020.190 · Cited by 52 · see citing works
“Safety planning intervention (SPI) 16 The 27 and the World Health Organization manual on surveillance and monitoring of suicide attempts and self-harm.”
Routine hospital management of self-harm and risk of further self-harm: propensity score analysis using record-based cohort data
Steeg, S., Emsley, R., Carr, M., Cooper, J., & Kapur, N. (2017) · Psychological Medicine · doi:10.1017/s0033291717001702 · Cited by 48 · see citing works
“Approaches using telephone and postal contact following self-harm have been studied in RCTs; results have been mixed though some studies have reported a reduction in the number of repeat selfharm episodes (Milner et al. 2015).”
ResultInfluential
Comparing the predictive value of screening to the use of electronic health record data for detecting future suicidal thoughts and behavior in an urban pediatric emergency department: A preliminary analysis
Haroz, E. E., Kitchen, C., Nestadt, P. S., Wilcox, H. C., DeVylder, J., & Kharrazi, H. H. K. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12800 · Cited by 47 · see citing works
“Potential interventions that could be linked to these strategies include safety planning (Stanley et al., 2018), brief contact interventions (Milner et al., 2015), and more intensive therapeutic interventions.”
Background
Effect of an Emergency Department Process Improvement Package on Suicide Prevention: The ED-SAFE 2 Cluster Randomized Clinical Trial
Boudreaux, E. D., Larkin, C., Vallejo Sefair, A., Ma, Y., Li, Y. F., Ibrahim, A. F., Zeger, W., Brown, G. K., Pelletier, L., Miller, I., et al. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.1304 · Cited by 46 · see citing works
Positive and negative life events and reasons for living modulate suicidal ideation in a sample of patients with history of suicide attempts
Bakhiyi, C. L., Jaussent, I., Béziat, S., Cohen, R. F., Genty, C., Kahn, J., Leboyer, M., Vaou, P. L., Guillaume, S., & Courtet, P. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.12.022 · Cited by 45 · see citing works
“be effective for suicide prevention in individuals with history of SA (Milner et al., 2015).”
Background
CASP – An intervention by community volunteers to reduce suicidal behaviour among refugees
Vijayakumar, L., Mohanraj, R., Kumar, S., Jeyaseelan, V., Sriram, S., & Shanmugam, M. (2017) · International Journal of Social Psychiatry · doi:10.1177/0020764017723940 · Cited by 44 · see citing works
Experience of Health Care Services After a Suicide Attempt: Results from an Online Survey
Shand, F., Batterham, P. J., Chan, J. K., Pirkis, J., Spittal, M. J., Woodward, A., & Christensen, H. M. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12399 · Cited by 44 · see citing works
Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial
Berrouiguet, S., Larsen, M. E., Mesmeur, C., Gravey, M., Billot, R., Walter, M., Network Hugopsy, Lemey, C., & Lenca, P. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.7780 · Cited by 42 · see citing works
Effectiveness of assertive case management on repeat self-harm in patients admitted for suicide attempt: Findings from ACTION-J study
Furuno, T., Nakagawa, M., Hino, K., Yamada, T., Kawashima, Y., Matsuoka, Y., Shirakawa, O., Ishizuka, N., Yonemoto, N., Kawanishi, C., et al. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.08.071 · Cited by 41 · see citing works
Prévention de la récidive suicidaire à l’adolescence par SMS ou autre media
Ligier, F., Guillemin, F., & Kabuth, B. (2017) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2017.03.011 · Cited by 40 · see citing works
Intergenerational Ties in Context: Association between Caring for Grandchildren and Cognitive Function in Middle-Aged and Older Chinese
Liao, S., Qi, L., Xiong, J., Yan, J., & Wang, R. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010021 · Cited by 40 · see citing works
“However, like other LMICs, China also lacks sufficient professional mental health resources [12,13] due to the high demand for professional resources [14,15], along”
Background
The effectiveness of remote delivered intervention for loneliness reduction in older adults: A systematic review and meta-analysis
Fu, Z., Yan, M., & Chao, M. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.935544 · Cited by 39 · see citing works
“The previous meta-analyses have drawn various conclusions depending on the types of study design (Choi et al., 2012; Milner et al., 2015; Noone et al., 2020; Jin et al., 2021).”
Method
Improving patient care after a suicide attempt
Shand, F., Vogl, L., & Robinson, J. (2018) · Australasian Psychiatry · doi:10.1177/1039856218758560 · Cited by 36 · see citing works
Patient perspectives on an intervention after suicide attempt: The need for patient centred and individualized care
Michaud, L., Dorogi, Y., Gilbert, S., & Bourquin, C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247393 · Cited by 39 · see citing works
“These components included coordination of care by a nurse case manager [11], the development of a joint crisis plan [12], early meeting with relatives and the already constituted care network [13] as well as phone contact over the span of three months after the suicide attempt [14].”
Background
Implementation of a text-messaging intervention for adolescents who self-harm (TeenTEXT): a feasibility study using normalisation process theory
Owens, C. V., & Charles, N. (2016) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-016-0101-z · Cited by 38 · see citing works
“A recent systematic review and meta-analysis offers tentative confirmation that the sending of postcards may reduce the rate of repetition of self-harm in some adults [20].”
Background
Implementation methods for the caring contacts suicide prevention intervention.
Reger, M. A., Luxton, D. D., Tucker, R. P., Comtois, K. A., Keen, A., Landes, S. J., Matarazzo, B. B., & Thompson, C. (2017) · Professional Psychology Research and Practice · doi:10.1037/pro0000134 · Cited by 38 · see citing works
“Therefore, although the literature is not unanimous (Beautrais et al., 2010), systematic reviews are optimistic about the intervention (Luxton et al., 2013; Milner et al., 2015).”
Background
Combining brief contact interventions (BCI) into a decision-making algorithm to reduce suicide reattempt: the VigilanS study protocol
Duhem, S., Berrouiguet, S., Debien, C., Ducrocq, F., Demarty, A.-L., Messiah, A., Courtet, P., Jehel, L., Thomas, P., Deplanque, D., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022762 · Cited by 38 · see citing works
“In 2015, Milner et al and Inagaki et al simultaneously published two meta-analyses assessing the effect of BCIs on suicide attempters.(10) 11 Their converging conclusions suggested that patients benefited from the recontact procedures, showing significantly lower relapse and suicide rates when compared with treated-as…”
Stakeholder Perspectives on Using and Developing the MYPLAN Suicide Prevention Mobile Phone Application: A Focus Group Study
Buus, N., Erlangsen, A., River, J., Andreasson, K., Frandsen, H., Larsen, J. L. S., Nordentoft, M., & Juel, A. (2018) · Archives of Suicide Research · doi:10.1080/13811118.2018.1489319 · Cited by 36 · see citing works
“There are several initiatives to provide brief contact interventions for people at risk of suicide and self-harm (Milner, Carter, Pirkis, Robinson, & Spittal, 2015).”
Background
Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention
Baldaçara, L., Grüdtner, R. R., Leite, V. D. S., Porto, D. M., Robis, K. P., Fidalgo, T. M., Rocha, G. A., Díaz, A. P., Meleiro, A. M. A. D. S., Corrêa, H., et al. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-1108 · Cited by 39 · see citing works
Machine learning algorithms and their predictive accuracy for suicide and self-harm: Systematic review and meta-analysis
Spittal, M. J., Guo, X. A., Kang, L., Kirtley, O. J., Clapperton, A., Hawton, K. E., Kapur, N., Pirkis, J., & Carter, G. L. (2025) · PLoS Medicine · doi:10.1371/journal.pmed.1004581 · Cited by 39 · see citing works
A Mobile Text Message Intervention to Reduce Repeat Suicidal Episodes: Design and Development of Reconnecting After a Suicide Attempt (RAFT)
Larsen, M. E., Shand, F., Morley, K. C., Batterham, P. J., Petrie, K., Reda, B., Berrouiguet, S., Haber, P., Carter, G. L., & Christensen, H. M. (2017) · JMIR Mental Health · doi:10.2196/mental.7500 · Cited by 34 · see citing works
“A meta-analysis found that postdischarge brief contact interventions, such as letters, postcards, crisis cards, and telephone calls, were associated with a significant reduction in the number of repeat episodes per participant, although nonsignificant reductions were observed in the number of patients with any repeat…”
Background
Suicide Risk Among Adults With Mental Health Emergency Department Visits With and Without Suicidal Symptoms
Olfson, M., Gao, Y. N., Xie, M., Cullen, S. W., & Marcus, S. C. (2021) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.20m13833 · Cited by 34 · see citing works
Suicide prevention: Towards integrative, innovative and individualized brief contact interventions
Berrouiguet, S., Courtet, P., Larsen, M. E., Walter, M., & Vaïva, G. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2017.09.006 · Cited by 33 · see citing works
Effectiveness of a French Program to Prevent Suicide Reattempt (VigilanS)
Plancke, L., Amariei, A., Danel, T., Debien, C., Duhem, S., Notredame, C.-É., Wathelet, M., & Vaïva, G. (2020) · Archives of Suicide Research · doi:10.1080/13811118.2020.1735596 · Cited by 32 · see citing works
“…the protection mechanisms suggested by the authors of the articles he had done the meta-analysis: social support, suicide prevention literacy and alternative learning behaviors are the three mechanisms found, most often in the introduction or discussion of articles (Milner et al., 2015, 2016).”
Background
Differences in the Effectiveness of Psychosocial Interventions for Suicidal Ideation and Behaviour in Women and Men: A Systematic Review of Randomised Controlled Trials
Krysinska, K. E., Batterham, P. J., & Christensen, H. M. (2016) · Archives of Suicide Research · doi:10.1080/13811118.2016.1162246 · Cited by 33 · see citing works
Overcoming Challenges to Evidence‐Based Policy Development in a Large, Integrated Delivery System
Frakt, A. B., Prentice, J. C., Pizer, S. D., Elwy, A. R., Garrido, M. M., Kilbourne, A. M., & Atkins, D. (2018) · Health Services Research · doi:10.1111/1475-6773.12986 · Cited by 33 · see citing works
Employing a sequential multiple assignment randomized trial (SMART) to evaluate the impact of brief risk and protective factor prevention interventions for American Indian Youth Suicide
The Celebrating Life Team, O’Keefe, V. M., Haroz, E. E., Goklish, N. A., Ivanich, J., Cwik, M. F., & Barlow, A. (2019) · BMC Public Health · doi:10.1186/s12889-019-7996-2 · Cited by 29 · see citing works
Combining green cards, telephone calls and postcards into an intervention algorithm to reduce suicide reattempt (AlgoS): P-hoc analyses of an inconclusive randomized controlled trial
Messiah, A., Notredame, C.-É., Demarty, A.-L., Duhem, S., Vaïva, G., & on behalf of AlgoS investigators (2019) · PLoS ONE · doi:10.1371/journal.pone.0210778 · Cited by 29 · see citing works
Ethical and Practical Considerations in the Use of a Predictive Model to Trigger Suicide Prevention Interventions in Healthcare Settings
Tucker, R. P., Tackett, M. J., Glickman, D. R., & Reger, M. A. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12431 · Cited by 28 · see citing works
A systematic review of suicide risk management strategies in primary care settings
Thangada, M. S., & Kasoju, R. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1440738 · Cited by 26 · see citing works
Caring E‐mails for Military and Veteran Suicide Prevention: A Randomized Controlled Trial
Luxton, D. D., Smolenski, D. J., Reger, M. A., Relova, R. M., & Skopp, N. A. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12589 · Cited by 26 · see citing works
Predictors and incidence rate of suicide re-attempt among suicide attempters: A prospective study
Esmaeili, E. D., Farahbakhsh, M., Sarbazi, E., Khodamoradi, F., Fam, S. G., & Azizi, H. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102999 · Cited by 25 · see citing works
Preventing repetition of attempted suicide—III. The Amager Project, 5-year follow-up of a randomized controlled trial
Lahoz, T., Hvid, M., & Wang, A. (2016) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2016.1180711 · Cited by 24 · see citing works
“This is also shown in a recent systematic review and random-effects meta-analysis of 12 randomized controlled trials using brief contact interventions such as telephone contacts, emergency crisis cards, postcards or letters, which showed positive results in reducing the frequency of individuals repeating suicide attem…”
Background
Developing a Hypothetical Model for Suicide Progression in Older Adults With Universal, Selective, and Indicated Prevention Strategies
Sakashita, T., & Oyama, H. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00161 · Cited by 26 · see citing works
“Hospital-based studies of indicated prevention interventions, including follow-up care after suicide attempts (37, 54), suggest these interventions were also not integrated with other prevention strategies.”
Background
SMS SOS: a randomized controlled trial to reduce self-harm and suicide attempts using SMS text messaging
Stevens, G. J., Hammond, T. E., Brownhill, S., Anand, M., de la Riva, A., Hawkins, J., Chapman, T., Baldacchino, R., Micallef, J.-A., Andepalli, J., et al. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2104-9 · Cited by 24 · see citing works
Veteran Preferences for the Caring Contacts Suicide Prevention Intervention
Reger, M. A., Gebhardt, H. M., Lee, J. M., Ammerman, B. A., Tucker, R. P., Matarazzo, B. B., Wood, A. E., & Ruskin, D. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12528 · Cited by 23 · see citing works
SAFETEL: a pilot randomised controlled trial to assess the feasibility and acceptability of a safety planning and telephone follow-up intervention to reduce suicidal behaviour
O’Connor, R. C., Smillie, S., McClelland, H., Lundy, J.-M., Stewart, C., Syrett, S., Gavigan, M., McConnachie, A., Stanley, B., Smith, M. J., et al. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01081-5 · Cited by 23 · see citing works
Engagement in physical activity, suicidal thoughts and suicide attempts among older people in five developing countries
Bishwajit, G., Wang, R., Tang, S., & Yaya, S. (2019) · PeerJ · doi:10.7717/peerj.7108 · Cited by 23 · see citing works
“Interventions, such as cognitive behavioral therapy and some antidepressants, have indeed been recognized as helpful in reducing risks of ST/SA; nevertheless, many require relatively intensive resources and are confined to a limited scale of population with poor viability in many contexts (Milner et al., 2015).”
Background
A Pilot Study of an Intervention to Prevent Suicide After Psychiatric Hospitalization
Riblet, N. B. V., Shiner, B. R., Schnurr, P. P., BRUCE, M. L., Wasserman, D., Cornelius, S. L., Scott, R. C., & Watts, B. V. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001061 · Cited by 21 · see citing works
“The study of Fleischmann et al. randomized 1699 patients to the World Health Organization Brief Intervention and Contact Program (WHO BIC) versus treatment as usual, and evaluated a more intense intervention that others included in the Milner et al. (2015) review.”
BackgroundMethod
Sex and age trends in Australia's suicide rate over the last decade: Something is still seriously wrong with men in middle and late life
Burns, R. A. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.08.036 · Cited by 22 · see citing works
Changes in the number of suicide re-attempts in a French region since the inception of VigilanS, a regionwide program combining brief contact interventions (BCI)
Djembi, L. F., Vaïva, G., Debien, C., Duhem, S., Demarty, A.-L., Koudou, Y. A., & Messiah, A. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-2443-6 · Cited by 21 · see citing works
The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review
Balcombe, L., & Leo, D. D. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.796371 · Cited by 22 · see citing works
Brief contact interventions to reduce suicide among discharged patients with mental health disorders—A meta‐analysis of RCTs
Tay, J. L., & Li, Z. (2022) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12903 · Cited by 21 · see citing works
Predicting Lifetime Suicide Attempts in a Community Sample of Adolescents Using Machine Learning Algorithms
Jankowsky, K., Steger, D., & Schroeders, U. (2023) · Assessment · doi:10.1177/10731911231167490 · Cited by 25 · see citing works
“However, it has been meta-analytically shown that brief-contact interventions only slightly reduced the overall number of repeated self-harm incidents per person and not the odds of death by suicide (Milner et al., 2015).”
Background
Taking care of suicidal patients with new technologies and reaching-out means in the post-discharge period
Falcone, G., Nardella, A., Lamis, D. A., Erbuto, D., Girardi, P., & Pompili, M. (2017) · World Journal of Psychiatry · doi:10.5498/wjp.v7.i3.163 · Cited by 20 · see citing works
Un exemple de système de veille post-hospitalière des suicidants : VigilanS
Jardon, V., Debien, C., Duhem, S., Morgiève, M., Ducrocq, F., & Vaïva, G. (2018) · L Encéphale · doi:10.1016/j.encep.2018.09.009 · Cited by 20 · see citing works
Brief Cognitive-Behavioral Therapy for Suicidal Inpatients
Diefenbach, G. J., Rudd, M. D., Merling, L. F., Davies, C. D., Katz, B. W., & Tolin, D. F. (2020) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.09.010 · Cited by 19 · see citing works
Interventions of choice for the prevention and treatment of suicidal behaviours: An umbrella review
Sufrate‐Sorzano, T., Santolalla‐Arnedo, I., Garrote‐Cámara, M. E., Nalda, B. A., Cotelo‐Sáenz, R., Pastells‐Peiró, R., Bellon, F., Blanco‐Blanco, J., Juárez‐Vela, R., & Molina‐Luque, F. (2023) · Nursing Open · doi:10.1002/nop2.1820 · Cited by 19 · see citing works
“…Lai et al. (2014) Lapierre (2011) Larsen et al. (2016) Macedo et al. (2014) Meerwijk et al. (2016) Melia et al. (2020) MéndezBustos et al. (2019) Milner et al. (2015) Milner et al. (2014) Okolie et al. (2017) Riblet et al. (2017) Robinson et al. (2016) Tighe et al. (2018) Winter et al.…”
BackgroundMethodInfluential
Untitled work
Teismann (2019) · doi:10.1159/000493887 · Cited by 18 · see citing works
Brief Interventions for Self-injurious Thoughts and Behaviors in Young People: A Systematic Review
Dobias, M. L., Chen, S., Fox, K. R., & Schleider, J. L. (2023) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-023-00424-9 · Cited by 25 · see citing works
Developing a post-discharge suicide prevention intervention for children and young people: a qualitative study of integrating the lived-experience of young people, their carers, and mental health clinicians
Watling, D. P., Preece, M. H. W., Hawgood, J. L., Bloomfield, S., & Kõlves, K. (2022) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-022-00460-3 · Cited by 18 · see citing works
A Systematic Review of Training Interventions for Emergency Department Providers and Psychosocial Interventions delivered by Emergency Department Providers for Patients who self-harm
Zarska, A., Barnicot, K., Lavelle, M., Dorey, T., & McCabe, R. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2022.2071660 · Cited by 18 · see citing works
“However, past research found follow-up contacts alone to be ineffective: two meta-analyses concluded the evidence was not sufficiently strong for it to be recommended (Hawton et al., 2016; Milner et al., 2015).”
Background
Interventions for attempted suicide
Menon, V., & Vijayakumar, L. (2022) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000807 · Cited by 17 · see citing works
“Interestingly, limited evidence (from three trials) suggested a significant reduction in repeat event rates (reattempts or repeat self-harm) [22].”
Background
Suicide reattempt in a population-wide brief contact intervention to prevent suicide attempts: The VigilanS program, France
Djembi, L. F., Debien, C., Demarty, A.-L., Vaïva, G., & Messiah, A. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.2221 · Cited by 17 · see citing works
“These monitoring programs are commonly referred to as "Brief Contact Interventions " (BCIs) [19, 20].”
BackgroundMethodResultInfluential
Development of the Veterans Crisis Line Caring Letters Suicide Prevention Intervention
Reger, M. A., Lauver, M., Manchester, C., Abraham, T. H., Landes, S. J., Garrido, M. M., Griffin, C., Woods, J. A., Strombotne, K. L., & Hughes, G. (2022) · Health Services Research · doi:10.1111/1475-6773.13985 · Cited by 16 · see citing works
Prevention of Suicidal Behavior with Telemedicine in Patients with a Recent Suicide Attempt: Is a 6‐month Intervention Long Enough?
Gabilondo, A., Aristegi, E., González-Pinto, A. M., Zurimendi, J. M., del Pino, M. M., Roca, R., Zorrilla, E. P., & Iruín, Á. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12576 · Cited by 14 · see citing works
Suicide Prevention Interventions and Their Linkages in Multilayered Approaches for Older Adults: A Review and Comparison
Sakashita, T., & Oyama, H. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.842193 · Cited by 13 · see citing works
“However, this follow-up care has often not been designed to be integrated with other prevention strategies (40, 42), which might limit its benefits.”
Background
An Emergency Department‐Initiated Intervention to Lower Relapse Risk after Attempted Suicide
Martínez‐Alés, G., Jiménez‐Sola, E., Román‐Mazuecos, E., Sánchez-Castro, P., de Dios, C., Vega, B. R., & Bravo‐Ortiz, M. F. (2019) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12542 · Cited by 13 · see citing works
Psychiatric intervention and repeated admission to emergency centres due to drug overdose
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Background
A pilot study of a text message and online brief contact intervention following self-harm or a suicide attempt: A mixed methods evaluation
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BackgroundInfluential

Effectiveness of brief interventions and contacts after suicide attempt: a systematic review and meta-analysis.
Homan, S., Marciniak, M. A., Michel, S., Bertram, A.-M., Rühlmann, C., Pethő, A., Kirchhofer, L., Biele, L., Segerer, R. K., Homan, P., et al. (2026) · Open Access CRIS of the University of Bern · doi:10.48620/96262
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Prevention of Re-attempt Suicide Through Brief Contact Interventions: A Systematic Review, Meta-analysis, and Meta-regression of Randomized Controlled Trials
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Authors: Milner, A. J., Carter, G., Pirkis, J., Robinson, J., & Spittal, M. J.
Affiliations: The University of Melbourne (AU)
ORCID: Milner, Allison J.
Pirkis, Jane
Robinson, Jo
Spittal, Matthew J.
Venue: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
Published: 2015-03
Volume: 206
Issue: 3
Pages: 184-190
ISSN: 0007-1250 (ISSN-L)
1472-1465
DOI: 10.1192/bjp.bp.114.147819
OpenAlex: W2123846655
Cited by: 211
References: 47
Citations by year: 2026: 6 · 2025: 15 · 2024: 17 · 2023: 19 · 2022: 21 · 2021: 24 · 2020: 17 · 2019: 21 · 2018: 21 · 2017: 22 · 2016: 21 · 2015: 6
FWCI: 3.35
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified, 1038 d)
Locations: The British Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Minerva Access (University of Melbourne) (submittedVersion)
Figshare (submittedVersion, cc-by)
NOVA (University of Newcastle Australia) (submittedVersion)
Funders: Medical Research Council
National Health and Medical Research Council (546248)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: self-harm, suicide attempts, suicide prevention, telephone-delivered intervention, postcards, intervention effectiveness
MeSH terms: Suicide Prevention, Humans, Postal Service, Psychotherapy, Brief, Suicide, Attempted, Telephone, Self-Injurious Behavior

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Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide.

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