CoChat
Sign Up
Cited by 20Suicide and Self-Harm StudiesPrimary Care and Health OutcomesPsychiatric care and mental health services

Continuity of care in suicide prevention: current status and future directions

Open access
Arnon, Shay, Shahar, Golan, Brunstein Klomek, Anat·2024·Frontiers in Public Health
DOI 10.3389/fpubh.2023.1266717PMC PMC10800998
Open this paper in CoChat — free accountOpen PDF

Abstract

Introduction: Continuity of Care (CoC) is central to suicide prevention. The present study aims to review contemporary definitions, operationalization in research, and key components of CoC in the prevention of suicide. Methods: The present study is a narrative review. A thorough search of available literature on CoC and suicidality was conducted. Studies published between 1995 and 2021 were reviewed and selected based on relevance to CoC and suicidality. Selected research was subsequently summarized to outline definitions of CoC, its operationalization in research, and key components for suicide prevention. Results: The definition, measurement, and operationalization of CoC in suicide prevention varies tremendously, derailing clinical practice. Key elements of CoC identified across the literature include (1) CoC across multiple levels of care, (2) the role of primary care providers and case managers in CoC of suicidal patients, (3) the importance of follow up contact with suicidal patients post-treatment, and (4) the role of national and institutional guidelines for CoC of suicidal patients. Limitations: There is a dearth of randomized controlled trials and insufficient evidence on specific populations. Conclusion: CoC refers to a wide, complex concept that must be broken down into specific categories that can provide more nuanced guidance of research and clinical implications.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fpubh.2023.1266717

Cites

9 of 9 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Suicide research has underlined the critical role of continuity of care.

    “Suicide research has underlined the critical role of continuity of care [19, 48].”

    From Suicide among youth and young adults in Canada: bereaved parents' perspectives on the systems of care (2025) · cites this paper as [48]

  • Arnon et al. identified four key elements for continuity of care in suicide prevention: continuity across multiple levels; the role of primary care providers and case managers; follow-up and monitoring after hospital discharge, ED visits, or transitions in care including mood and suicide risk assessment and safety plan review; and national and institutional guidelines, standards, and best practic

    “Arnon et al. [48] identified four key elements for continuity of care in suicide prevention. These elements include (1) continuity of care across multiple levels, including inpatient and outpatient services; (2) the important role of primary care providers and case managers; (3) the importance of follow-up and monitoring after hospital discharge, ED visits, or during transitions in care, which”

    From Suicide among youth and young adults in Canada: bereaved parents' perspectives on the systems of care (2025) · cites this paper as [48]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 40

  1. [2]Zalsman G Hawton K Wasserman D van Heeringen K Arensman E Sarchiapone M. Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry. (2016) 3: 646– 59. doi: 10.1016/S2215-0366(16)30030-X, PMID: 27289303 · DOI · Paper page
  2. [5]Choi Y Nam CM Lee SG Park S Ryu HG Park EC. Association of continuity of care with readmission, mortality and suicide after hospital discharge among psychiatric patients. Int J Qual Health Care. (2020) 32: 569– 76. doi: 10.1093/intqhc/mzaa093, PMID: 32797161 · DOI
  3. [6]King EA Baldwin DS Sinclair JMA Baker NG Campbell MJ Thompson C. The Wessex recent in-patient suicide study, 1: case–control study of 234 recently discharged psychiatric patient suicides. Br J Psychiatry. (2001) 178: 531– 6. doi: 10.1192/bjp.178.6.531, PMID: 11388969 · DOI
  4. [8]Kim W Jang SY Lee TH Lee JE Park EC. Association between continuity of care and subsequent hospitalization and mortality in patients with mood disorders: results from the Korea National Health Insurance cohort. Puyat JH, editor. PLoS One. (2018) 13: e0207740. doi: 10.1371/journal.pone.0207740 30452465 PMC6242689 · DOI
  5. [9]Mehlum L Mork E. After the suicide attempt: the need for continuity and quality of care In: International handbook of suicide prevention: research, policy and practice: O’Connor R. C. Platt S. Gordon J. (eds.) Chicshter: John Wiley & Sons, Ltd. (2016). 353– 67.
  6. [13]Wasserman D Iosue M Wuestefeld A Carli V. Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry. (2020) 19: 294– 306. doi: 10.1002/wps.20801, PMID: 32931107 PMC7491639 · DOI
  7. [14]Brodsky BS Spruch-Feiner A Stanley B. The zero suicide model: applying evidence-based suicide prevention practices to clinical care. Front Psych. (2018) 9: 33. doi: 10.3389/fpsyt.2018.00033, PMID: 29527178 PMC5829088 · DOI
  8. [15]American Psychiatric Association Task Force on Psychiatric Emergency Services. Report and recommendations regarding psychiatric emergency and crisis services: a review and model program descriptions. Washington D.C.: (2002).
  9. [16]Bice TW Boxerman SB. A quantitative measure of continuity of care. Med Care. (1977) 15: 347– 9. doi: 10.1097/00005650-197704000-00010 859364 · DOI · Paper page
  10. [17]Meehan J Kapur N Hunt IM Turnbull P Robinson J Bickley H. Suicide in mental health in-patients and within 3 months of discharge: national clinical survey. Br J Psychiatry. (2006) 188: 129– 34. doi: 10.1192/bjp.188.2.129, PMID: 16449699 · DOI
  11. [18]Mehlum L Jørgensen T Diep LM Nrugham L. Is organizational change associated with increased rates of readmission to general hospital in suicide attempters? A 10-year prospective catchment area study. Arch Suicide Res. (2010) 14: 171– 81. doi: 10.1080/13811111003704811, PMID: 20455152 · DOI
  12. [19]Mehlum L Mork E Reinholdt NP Fadum EA Rossow I. Quality of psychosocial care of suicide attempters at general hospitals in Norway—a longitudinal nationwide study. Arch Suicide Res. (2010) 14: 146– 57. doi: 10.1080/13811111003704753, PMID: 20455150 · DOI
  13. [20]Mork E Mehlum L Fadum EA Rossow I. Collaboration between general hospitals and community health services in the care of suicide attempters in Norway: a longitudinal study. Ann General Psychiatry. (2010) 9: 26. doi: 10.1186/1744-859X-9-26, PMID: 20540725 PMC2894819 · DOI
  14. [21]Oordt MS Jobes DA Rudd MD Fonseca VP Runyan CN Stea JB. Development of a clinical guide to enhance care for suicidal patients. Prof Psychol Res Pract. (2005) 36: 208– 18. doi: 10.1037/0735-7028.36.2.208 · DOI
  15. [22]Riblet NBV Shiner B Young-Xu Y Watts BV. Strategies to prevent death by suicide: Meta-analysis of randomised controlled trials. Br J Psychiatry. (2017) 210: 396– 402. doi: 10.1192/bjp.bp.116.187799, PMID: 28428338 · DOI · Paper page
  16. [23]Riblet N Shiner B Scott R Bruce ML Wasserman D Watts BV. Exploring psychiatric inpatients’ beliefs about the role of post-discharge follow-up care in suicide prevention. Mil Med. (2019) 184: e91– e100. doi: 10.1093/milmed/usy129, PMID: 29860477 PMC8801294 · DOI
  17. [24]Rossow I Mehlum L Gjertsen F Møller B. Chain of care for patients with intentional self-harm: an effective strategy to reduce suicide rates? Suicide Life Threat Behav. (2009) 39: 614– 22. doi: 10.1521/suli.2009.39.6.614, PMID: 20121324 · DOI
  18. [25]Uijen AA Schers HJ Schene AH Schellevis FG Lucassen P van den Bosch WJHM. Experienced continuity of care in patients at risk for depression in primary care. Eur J Gen Pract. (2014) 20: 161– 6. doi: 10.3109/13814788.2013.828201 24033228 · DOI
  19. [26]Bauer AM Chan YF Huang H Vannoy S Unützer J. Characteristics, management, and depression outcomes of primary care patients who endorse thoughts of death or suicide on the PHQ-9. J Gen Intern Med. (2013) 28: 363– 9. doi: 10.1007/s11606-012-2194-2, PMID: 22936288 PMC3579977 · DOI
  20. [28]Carrigan CG Lynch DJ. Managing suicide attempts: guidelines for the primary care physician. Prim Care Companion J Clin Psychiatry. (2003) 5: 169– 74. doi: 10.4088/PCC.v05n0405, PMID: 15213779 PMC419387 · DOI
  21. [29]De Leo D Draper BM Snowdon J Kõlves K. Contacts with health professionals before suicide: missed opportunities for prevention? Compr Psychiatry. (2013) 54: 1117– 23. doi: 10.1016/j.comppsych.2013.05.007, PMID: 23768696 · DOI
  22. [31]Luoma JB Martin CE Pearson JL. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psychiatry. (2002) 159: 909– 16. doi: 10.1176/appi.ajp.159.6.909, PMID: 12042175 PMC5072576 · DOI · Paper page
  23. [32]Schulberg HC Bruce ML Lee PW Williams JW Dietrich AJ. Preventing suicide in primary care patients: the primary care physician’s role. Gen Hosp Psychiatry. (2004) 26: 337– 45. doi: 10.1016/j.genhosppsych.2004.06.007 15474633 · DOI
  24. [33]Udo C Svenningsson I Björkelund C Hange D Jerlock M Petersson E. An interview study of the care manager function—opening the door to continuity of care for patients with depression in primary care. Nurs Open. (2019) 6: 974– 82. doi: 10.1002/nop2.277, PMID: 31367421 PMC6650652 · DOI
  25. [34]Unützer J Katon W Callahan CM Williams JW Jr Hunkeler E Harpole L. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. (2002) 288: 2836– 45. doi: 10.1001/jama.288.22.2836, PMID: 12472325 · DOI · Paper page
  26. [35]Cedereke M Monti K Öjehagen A. Telephone contact with patients in the year after a suicide attempt: does it affect treatment attendance and outcome? A randomised controlled study. Eur Psychiatry. (2002) 17: 82– 91. doi: 10.1016/S0924-9338(02)00632-6, PMID: 11973116 · DOI · Paper page
  27. [36]Fleischmann A. Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries. Bull World Health Organ. (2008) 86: 703– 9. doi: 10.2471/BLT.07.046995, PMID: 18797646 PMC2649494 · DOI · Paper page
  28. [38]Joyce HD Fontanella CA Phillips G. Continuity of care and adherence to antidepressant treatment among medicaid-covered youth. Soc Work Ment Health. (2013) 11: 267– 87. doi: 10.1080/15332985.2012.749826 · DOI
  29. [39]Katon W Rutter C Ludman EJ Von Korff M Lin E Simon G. A randomized trial of relapse prevention of depression in primary care. Arch Gen Psychiatry. (2001) 58: 241. doi: 10.1001/archpsyc.58.3.241 11231831 · DOI
  30. [40]Labouliere CD Vasan P Kramer A Brown G Green K Rahman M. “Zero suicide” – a model for reducing suicide in United States behavioral healthcare. Suicidologi. (2018) 23: 22– 30. doi: 10.5617/suicidologi.6198, PMID: 29970972 PMC6022755 · DOI · Paper page
  31. [43]Simon GE Ralston JD Savarino J Pabiniak C Wentzel C Operskalski BH. Randomized trial of depression follow-up care by online messaging. J Gen Intern Med. (2011) 26: 698– 704. doi: 10.1007/s11606-011-1679-8, PMID: 21384219 PMC3138593 · DOI
  32. [44]Solberg LI Trangle MA Wineman AP. Follow-up and follow-through of depressed patients in primary care: the critical missing components of quality care. J Am Board Fam Med. (2005) 18: 520– 7. doi: 10.3122/jabfm.18.6.520, PMID: 16322414 · DOI
  33. [45]Stanley B Chaudhury SR Chesin M Pontoski K Bush AM Knox KL. An emergency department intervention and follow-up to reduce suicide risk in the VA: acceptability and effectiveness. Psychiatr Serv. (2016) 67: 680– 3. doi: 10.1176/appi.ps.201500082 26828397 · DOI · Paper page
  34. [46]Stanley B Brown GK Brenner LA Galfalvy HC Currier GW Knox KL. Comparison of the safety planning intervention with follow-up vs usual care of suicidal patients treated in the emergency department. JAMA Psychiatry. (2018) 75: 894– 900. doi: 10.1001/jamapsychiatry.2018.1776, PMID: 29998307 PMC6142908 · DOI · Paper page
  35. [49]Haggerty JL Reid RJ Freeman GK Starfield BJ Adair CE McKendry R. Continuity of care: a multidisciplinary review. BMJ. (2003) 327: 1219– 21. doi: 10.1136/bmj.327.7425.1219, PMID: 14630762 PMC274066 · DOI · Paper page
  36. [50]Jee SH Cabana MD. Indices for continuity of care: a systematic review of the literature. Med Care Res Rev. (2006) 63: 158– 88. doi: 10.1177/1077558705285294 16595410 · DOI
  37. [51]Gensichen J Peitz M Torge M Mosig-Frey J Wendt-Hermainski H Rosemann T. The “depression monitoring list” (DeMoL) with integrated PHQ-D-rationale and design of a tool for the case management for depression in primary care. Z Arztl Fortbild Qualitatssich. (2006) 100: 375– 82. PMID: 16955623
  38. [53]Alanee S Alvarado-Cabrero I Murugan P Kumar R Nepple KG Paner GP. Update of the international consultation on urological diseases on bladder cancer 2018: non-urothelial cancers of the urinary bladder. World J Urol. (2019) 37: 107– 14. doi: 10.1007/s00345-018-2421-5, PMID: 30069580 · DOI
  39. [54]Hom MA Stanley IH Joiner TE. Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: a review of the literature. Clin Psychol Rev. (2015) 40: 28– 39. doi: 10.1016/j.cpr.2015.05.006 26048165 · DOI · Paper page
  40. [55]Lai DWL Li L Daoust GD. Factors influencing suicide behaviours in immigrant and ethno-cultural minority groups: a systematic review. J Immigr Minor Health. (2017) 19: 755– 68. doi: 10.1007/s10903-016-0490-3, PMID: 27640011 · DOI

Cited by

Sorted by citations

Authors
Arnon, S., Shahar, G., & Brunstein Klomek, A.
Affiliations
  • Reichman University (IL)
  • Ben-Gurion University of the Negev (IL)
ORCID
Venue
Frontiers in Public Health
Publisher
Frontiers Media SA
Published
2024-01-08
Volume
11
Pages
1266717-1266717
ISSN
2296-2565 (ISSN-L)
DOI
10.3389/fpubh.2023.1266717
PMC
PMC10800998
OpenAlex
W4390665329
Cited by
20
References
9
Citations by year
2026: 11 · 2025: 8 · 2024: 1
FWCI
1.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Israeli Ministry of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
continuity of care, suicide prevention, suicidality, primary care providers, case managers, follow-up contact, post-treatment follow-up, care guidelines, suicidal patients
MeSH terms
Continuity of Patient Care, Humans, Research Design, Suicide, Suicidal Ideation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review