Suicide and Attempts Prevented with Therapy

Short and long term psychosocial therapy decreases the risk of deliberate self harm and suicide, according to findings published in The Lancet Psychiatry.

Researchers from the Johns Hopkins Bloomberg School of Public Health examined 65,000 people in Denmark who attempted suicide between January 1, 1992 and December 31, 2010. Of that group, 5,678 people underwent psychosocial therapy at one of 8 suicide prevention clinics. Those patients were matched with 17,034 individuals — whose 31 suicide attempt factors looked similar to the psychosocial therapy group – who did not undergo therapy. All patients were monitored for a follow up period of 20 years.

Generally, the researchers acknowledged that a randomized study in which some patients receive therapy and some do not is unethical. However, this study took advantage of the Danish clinics that were introduced to society slowly, which presented extensive baseline and long term follow up data for a large population. Previously, it was difficult to determine if suicide prevention treatment programs were effective because of the ethical boundaries.

During the first year, participants in the psychosocial therapy group were 27 percent less likely to attempt suicide again and 38 percent less likely to die of any cause. At the 5 year follow up point, there were 26 percent fewer suicides in the therapy group compared to the group who did not receive therapy. At 10 years after baseline measurements, the suicide rate for those who had therapy was 229 per 100,000 while among the rate those who did not receive therapy was 314 per 100,000. The research team estimated 145 suicide attempts and 30 deaths were prevented in the therapy group.

“We know that people who have attempted suicide are a high risk population and that we need to help them,” the study's leader, Annette Erlangsen, DPH, an adjunct associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, said in a press release. “However, we did not know what would be effective in terms of treatment. Now we have evidence that psychosocial treatment — which provides support, not medication – is able to prevent suicide in a group at high risk of dying by suicide.”

The type of therapy received varied across the 8 clinics, so researchers were not able to pinpoint what exactly helped each patient prevent further suicide attempts. The investigators hypothesize that it could have simply been the providing of a safe and confidential space to talk, but want to do more research into why specific types of therapy seem to be more effective than others.