Evaluation of a community-based assertive follow-up suicide prevention program for people who have attempted suicide or are at high risk of suicide

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The study aims to evaluate the efficacy of a community-based assertive aftercare follow-up suicide prevention program in reducing repeat suicide attempts for people who have presented to the participating emergency departments following a suicide attempt or with high risk of suicide. A secondary aim of the study is to measure changes in known suicide risk factors (e.g. depressed mood, psychache) for people who participated in the intervention. The assertive follow-up intervention will be delivered by mental health clinicians and peer workers, using both face-to-face interventions and phone follow-up sessions, for a duration of four weeks (with an option of extension to 12 weeks). The intervention is based on the GROW coaching model and will utilise the Suicide Status Form-4 (SSF-4) from the Collaborative Assessment and Management of Suicide (CAMS) model (Jobes, 2016; Jobes, Jacoby, Cimbolic, & Hustead, 1997). Participants will be asked to outline the key issues that are contributing to their suicide risk, and in collaboration with a clinician, will produce a set of goals and objectives for addressing these issues in a set timeframe, and follow a stabilisation plan. Participants will re-rate their suicide risk factors and evaluate their goals and stabilisation plan at each contact with a clinician or peer worker. Quantitative and qualitative measures of progress toward goals, stabilisation plan and suicide risk will be monitored using the SSF-4 at each contact, measuring psychological pain, agitation, stress, hopelessness, self-hate and overall risk. It is hypothesised that; 1. Compared to health consumers who receive treatment as usual (TAU) following their episode of care in an emergency department as a result of a suicide attempt or high risk of suicide, participants of the Aftercare intervention will be significant less likely to re-present to an emergency department for suicide attempt or high risk of suicide. 2. Compared to health consumers who receive TAU following their episode of care in an emergency department for suicide attempt or high risk of suicide, participants of the Aftercare intervention will experience a significant reduction in the number repeat suicide attempts (as measured by re-presentations to an emergency department for a suicide attempt or being deemed to be at high risk of suicide). 3. Compared to health consumers who receive treatment as usual (TAU) following their episode of care in an emergency department as a result of a suicide attempt or high risk of suicide, participants of the Aftercare intervention will be significant less likely to die by any cause in 24 months. 4. Participants of the Aftercare intervention will show significant reductions in suicide risk factors following the intervention.