Please select the eligibility criteria that correspond to the clinical trial below.
Title: Assessment of Preventive Efficacy of an Algorithm Taking Place After Suicide Attempts Among Attempters Admitted to Hospital in the French Overseas Territories
Brief Summary: 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.


Options:
A: 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
B: Inclusion Criteria:

1. Be aged over 16 years (parental consent is not needed; The British Psychological Society, 2008)
2. Be comfortable with and have access to email and the internet for completing study measures
3. Be currently under or receiving support form clinical/health service including NHS, 3rd sector, or University health services
4. Following DSM-V (American Psychiatric Association, 2013), have had five or more instances of NSSI in the past year:

   • NSSI methods are operationalised to include cutting, burning, biting, or scratching oneself, as well as head-banging or self-poisoning.
5. Have an adequate English language ability to understand study materials
6. Be deemed capable of providing informed consent by their clinical team.

Exclusion Criteria:

1. Be currently receiving any other psychological therapy (e.g. including but not limited to CBT and/or DBT), and will not have received psychological therapies in the last one month.
2. Have previously received any CAT
3. Have been diagnosed with Learning Disability or Autistic Spectrum Disorder as judged by clinical team - since the intervention has not been developed for this population
4. Be currently judged at high risk of suicidal behaviour (although if participants were keen to be involved, they could be considered when their mental health has improved).
5. Have been hospitalised as a result of self-harm in the past month
C: Inclusion Criteria:

* Meets Diagnostic and Statistical Manual (DSM-IV) criteria for borderline personality disorder (BPD)
* Attempted suicide in the past 2 months
* At least one additional suicide attempt, suicide-related behavior, or self-injury episode in the past year
* Current suicidal ideation
* Able to be managed as an outpatient
* Not currently receiving optimum psychiatric treatment and agrees to notify study staff if any psychiatric care outside this study is sought. If care other than that permitted by the protocol is utilized, participants can no longer be enrolled in the study.
* Has a stable living arrangement at study entry
* Speaks English
* Willing and judged to be clinically able to undergo wash-out of psychotropic medications, except for occasional benzodiazepines use, for 2 to 6 weeks before treatment
* Females must be willing to use an effective method of birth control.

Exclusion Criteria:

* Meets the DSM-IV criteria for mental retardation or the following disorders: bipolar I, schizophrenia, delusional disorder, schizophreniform disorder, schizoaffective disorder, or psychotic disorder not otherwise specified (NOS)
* Needs priority treatment for acute medical illness or other debilitating problem, such as severe substance dependence or anorexia
* Pregnant
* Clinically too unstable to be maintained as an outpatient
* Has clearly failed adequate trials of fluoxetine and citalopram for a major depression in the past 2 years
* History of severe allergies, adverse drug reactions, or known allergy to fluoxetine or citalopram
* Clinically inadvisable for the participant to end current treatment
* Heart pacemaker body implant; other metal implants, such as shrapnel or surgical prostheses; or paramagnetic objects contained within the body, as assessed via a metal screening questionnaire, which may present a risk to the participant or interfere with the fMRI scan
* Diagnosed with Raynaud's disorder
* History of hypertension, cardiovascular disease, or abnormal electrocardiograms (EKGs)
* Claustrophobia or significant discomfort in enclosed space
D: Inclusion Criteria:

* Current episodes of self-harm and/or recurrent suicidality.
* Fulfilling at least three criteria for borderline personality disorder.
* Admitted to psychiatric hospital for acute care for at least 7 days or presenting to the psychiatric emergency department at least 3 times during the last six months.

Exclusion Criteria:

* No regular contact with outpatient psychiatric services.
* Homelessness. Housing crises are outside the scope of this RCT.
* Medical disorder from other organs that significantly contributes to inclusion criteria (e.g. if self-harm only occurs during episodes of hypoglycemia in a diabetic patient).

Answer: A