Suicide Prevention Algorithm in the French Overseas Territories (APSOM)

University Hospital Center of Martinique

Status: Completed

Conditions: Suicide Attempt

Treatments: Other: APSOM vs Control

Study type: Interventional

Funder types: Other

Identifiers

NCT03427190

15/B/04

Details and patient eligibility

About

In France, suicide behaviours are a major public health concern that triggered the creation in 2013 of a National Observatory of Suicide. In continental France, the "Algos" protocol was found to be effective for the prevention of suicide attempts reiterations. This protocol is based on a procedure that keeps telephone and postal contacts with the suicide attempter and allows, via an algorithm, to assess the risk of suicide attempt recurrence, in order to intervene if necessary. Nevertheless, Algos does not involve primary care health practitioners, who could add a substantial additional efficacy, especially if they intervene downstream and in supplement to Algos. In addition, this kind of protocol has never been evaluated in the French overseas territories.

Full description

Since (1) Algos was never implemented in the French overseas departments (FOD) and does not involve primary care practitioners (PCP), (2) the additional effect of PCP involvement over and beyond Algos alone in unknown, and (3) little research on suicide behaviours has been conducted in the FOD, this proposal has the following main aim: to assess the effectiveness and the efficacy of the intervention, in supplement and downstream to Algos, of a healthcare professional, on the recurrence of suicide attempts in the FOD; the healthcare professional will be the patient's general practitioner, whenever possible.

Enrollment: 259 patients

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Man or woman over 16 years of age
• Leaving the hospital within 15 days of the suicide attempt
• Giving (him/herself or his/her legal representative)an oral consent to participate in the study
• Having healthcare insurance
• Reachable by phone, with possibility of confidential conversation, and by mail
• Resident of Guadeloupe, French Guyana, Martinique, or Reunion Island
• Able to understand and speak French

Exclusion criteria

• Homeless person
• Disabled adult, person under judicial/court protection, legally incompetent adult
• Participant unable to understand the study protocol, its risks and side effects, or declining to participate

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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259 participants in 2 patient groups

Control

Active Comparator group

Description:

Phone contact with patient will be made by a professional psychologist within 21 days of hospital discharge. If contact cannot be made after 9 attempts, post-cards will be sent monthly at M2, M3, M4 and M5, asking the participant to establish contact with the designated psychologist. The phone call will determine whether or not the participant is in a state of suicidal crisis. If yes, steps will be taken to attend the crisis within 24 hours.

Treatment:

Other: APSOM vs Control

APSOM

Other group

Description:

In complement to actions described in the control arm, the patient's general practitioner (GP) and the patient him/herself will be contacted within 21 days of hospital discharge in order to organize an appointment between them two; this consultation is expected to take place between day 22 and day 45 after hospital discharge. If the patient does not have a GP, a health-care professional (HCP) will be provided. .GP (or HCP) will also be contacted at 6 and 13 months.

Treatment:

Other: APSOM vs Control