Suicide-Specific Psychotherapy for the Treatment of Suicidal Crisis: Clinical Effectiveness

Key Message

Three randomized controlled trials, and two reports of one non-randomized cohort study were identified describing the clinical effectiveness of suicide-specific interventions versus interventions without a suicide-specific focus for those experiencing a suicidal crisis. One of the included randomized controlled trials examined United States military personnel whereas the remaining studies examined civilian patients and individuals. The two reports of a non-randomized study described pilot results in the earlier paper and longer-term follow-up in the later paper. No eligible studies were identified describing the comparative clinical effectiveness of two or more suicide-specific interventions for suicidal crisis. Three randomized controlled trials reported improvements in suicidal ideation and behaviour after both suicide-specific and non-suicide-specific interventions; but described no consistent, statistically significant differences overall between groups of patients receiving these interventions. Two reports of a non-randomized study emphasized a statistically significant improvement in suicidal ideation and behaviour between hospital admission and discharge for inpatients receiving a suicide-specific intervention versus a non-suicide-specific intervention; however, these relative improvements were not sustained at six months of follow up. Other outcomes investigated included measures of mental health, well-being, and health care utilization. Similar to the suicide-specific outcomes, included studies generally reported improvements in mental health, well-being and health care utilization outcomes in patients receiving either suicide-specific or non-suicide-specific interventions; however, sustained differences between treatment groups were not observed. Authors of most included studies suggested that suicide-specific and non-suicide-specific interventions are effective interventions for patients experiencing suicidal crisis. However, given the lack of long-term or consistent data supporting the comparative effectiveness of suicide-specific versus non-suicide specific interventions; research from additional studies remains necessary.