Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

Int J Environ Res Public Health. 2020 Apr 10;17(7):2599. doi: 10.3390/ijerph17072599.


The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13-0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09-0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts.

Keywords: case management; intervention; suicide; suicide attempts.

MeSH terms

  • Adult
  • Case Management*
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Republic of Korea / epidemiology
  • Risk
  • Risk Factors
  • Suicide, Attempted*
  • Young Adult