Randomized Controlled and Prospective Trial of a Cohort of People Who Made a Suicide Attempt (OSTA)

• suicide attempts frequency [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  Number of occurrence of suicide attempts.
• Adherence to health care [ Time Frame: 12 months ] [ Designated as safety issue: No ]

  Adherence to health care:

  Defined by:

  • The Initialization of outpatient care proposed by the suicidology's team at the initial interview or during telephone contacts.
  • The number of consultations within 3 months after the first appointment with the referring doctor.
• Number of eligibles persons [ Time Frame: 12 months ] [ Designated as safety issue: No ]

  Number of eligibles persons:

  Number of people (among all people admitted to the emergency department fo a suicide attempt) meeting the criteria of selection.

• Number of participants responding to telephone calls [ Time Frame: 12 months ] [ Designated as safety issue: No ]

  Number of participants responding to telephone calls:

  We consider the failure to call after three unsuccessful telephone calls to three different days.

• Number of people lost sight of [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]

  Number of people lost sight of:

  A person is considered lost sight if no information can be obtained after contact with the person himself, a third (nearest designated), a doctor (general practitioner and / or psychiatrist) and the nearest emergency department.

The prevention of recurrent suicidal about people who have made a suicide attempt is a major strand in the prevention of suicide. It is estimated that 10-15 % of people who made a suicide attempt die by suicide. Recidivism rate of suicide increases even faster than the subject is close to the index suicide attempt. A one month recurrence rate is 5 %, 12-25 % at one year. Most people who made a suicide attempt receive ambulatory monitoring. On this population, there is a low adherence to care.

The main objective of the study is to test the effectiveness of a prevention program of recurrent suicidal acts for people who made a suicide attempt.

The secondary objectives of this study are the assessment of adherence to care; the identification of sub - populations benefiting most from this program; the evaluation of the possible generalization level of the program (eligibles persons rate) and its feasibility level.

This is a randomized, controlled and prospective trial comparing an experimental group (usual treatment + interventions) to a control group (usual treatment only). All participants are evaluated after one year of monitoring. The search duration is 2 years (one inclusion year and one year of follow-up). It is planned to include 330 patients, 165 patients in each group.

The program (experimental group) includes three interventions:

• A series of three telephone calls ( the second week , one month and three months after discharge from hospital )
• A systematic telephone contact with the referring physician
• A telephone helpline for people who made a suicide attempt and referring physicians.

• Other: Usual treatment and Prevention program

  Prevention program of recurrent suicidal acts includes three interventions:

  • A series of three telephone calls ( the second week , one month and three months after discharge from hospital )
  • A systematic telephone contact with the referring physician
  • A telephone helpline for people who made a suicide attempt and referring physicians.
  Other Name: Prevention program
• Other: Usual Treatment
  Usual Treatment
  Other Name: Usual Treatment

• Experimental: Interventional group
  Usual treatment + prevention program of recurrent suicidal acts
  Intervention: Other: Usual treatment and Prevention program
• Active Comparator: Control group
  Usual treatment
  Intervention: Other: Usual Treatment

Inclusion Criteria:

• Adults ≥ 18 years.
• Patients admitted to the emergency department for a suicide attempt.
• Patients referred to outpatient care.
• Patients who have given their written consent.

Exclusion Criteria:

• Patients not affiliated to social security.
• Patients do not have the faculties needed to be evaluated (cognitive or delusional disorder).
• Patients hospitalized for longer than 72 hours.
• Patients can not be recalled by phone (no phone, homeless, incarcerated)
• Patients who do not speak French.