Effect of Psychosocial Treatment by the Case Manager in Patients After a Suicide Attempt

• treatment adherence, defined as outpatient mental health clinic attendance [ Time Frame: 6-month, and 12-month ] [ Designated as safety issue: Yes ]
  

• During follow-up periods (6-month, and 12-month), interventional group will have (1) less repeated suicide attempts (behavior) (2) less suicidal ideation, (3) lower depression score, (4) better patients' satisfaction with care [ Time Frame: 6-month, and 12-month ] [ Designated as safety issue: Yes ]
  

Other: proactive psychosocial intervention by care managers
A case manager will be assigned to each of the participants in the intervention group. All case managers are psychologists. After discharge from the emergency department, the participants receive six sessions of proactive psychosocial intervention by their case manager over four months. Duration of each session is approximately 30 minutes. The intervention consists of telephone or face-to-face contacts with the case manager at scheduled intervals or when clinically necessary. If a patient declines medication therapy from the psychiatrist, case manager will provide psychotherapy using the model of cognitive-behavioural approach and problem-solving therapy. Case managers will receive backup and supervision by psychiatrist investigators and monthly supervision of therapy. Case managers will regularly monitor suicide risk, clinical status and provide follow-up.

Compared with usual care, interventional group will (1) improve treatment attendance, (2) have less repeated suicide attempts in adults after a suicide attempts, and (3)have better patients' satisfaction with care.