Communication-based suicide prevention after the first attempt. A systematic review
Authors: Katsivarda Cecilia , Assimakopoulos Konstantinos , Jelastopulu Eleni 
Published: March 2021

Previous suicide attempts are the strongest risk factor for a new suicide attempt, suicide death, the development of recurrent suicide behavior and even the development of suicidal ideation in the general population. Primary prevention aims to reduce new suicide attempts in the general population, while secondary prevention tries to reduce the chance of suicide attempts in patients with high risk. Tertiary interventions are targeted at individuals who have already made one or more suicide attempts and aim to prevent second or repetitive attempts and to suppress suicidal behavior. Communication with patients and family is a very effective way of preventing a second suicide attempt. The aim of this paper is to present an overview of tertiary suicide prevention interventions focusing on communication with the patient and their family and study their effectiveness. This systematic review was based on the PRISMA checklist and was conducted using the databases Pubmed, Scopus and Google Scholar for articles published between 2000 and 2020 focus in go communication with family and patient. All studies concerning at least one previous suicide attempt were included. The interventions described in the studies concerned: [1] face-to-face and telephone contacts, [2] communication with greeting cards and letters, [3]telephone contact with the patient and record keeping to facilitate the implementation of the action plan, [4] telephone contacts only, and [5] technology-based communication. Our investigation brought up9 studies on interventions focusing on communication with the patient and their family. Family and patient communication interventions, with a particular emphasis on telephone and written communication, have shown a good level of effectiveness in the prevention of a new suicide attempt, especially if the intervention has been completed according to the schedule and the patient has not abandoned the treatment early. The generalization of the results is limited due to the inclusion of other types of studies jointly with randomized controlled trials and the variability among the samples of the studies. In conclusion, family and patient communication interventions have shown a positive effect on preventing a second suicide attempt. More studies are needed to investigate the effectiveness of different prevention approaches at hand and clarify in which patient populations each intervention could be more effective.Previous suicide attempts are the strongest risk factor for a new suicide attempt, suicide death, the development of recurrent suicide behavior and even the development of suicidal ideation in the general population. Primary prevention aims to reduce new suicide attempts in the general population, while secondary prevention tries to reduce the chance of suicide attempts in patients with high risk. Tertiary interventions are targeted at individuals who have already made one or more suicide attempts and aim to prevent second or repetitive attempts and to suppress suicidal behavior. Communication with patients and family is a very effective way of preventing a second suicide attempt. The aim of this paper is to present an overview of tertiary suicide prevention interventions focusing on communication with the patient and their family and study their effectiveness. This systematic review was based on the PRISMA checklist and was conducted using the databases Pubmed, Scopus and Google Scholar for articles published between 2000 and 2020 focus in go communication with family and patient. All studies concerning at least one previous suicide attempt were included. The interventions described in the studies concerned: [1] face-to-face and telephone contacts, [2] communication with greeting cards and letters, [3]telephone contact with the patient and record keeping to facilitate the implementation of the action plan, [4] telephone contacts only, and [5] technology-based communication. Our investigation brought up9 studies on interventions focusing on communication with the patient and their family. Family and patient communication interventions, with a particular emphasis on telephone and written communication, have shown a good level of effectiveness in the prevention of a new suicide attempt, especially if the intervention has been completed according to the schedule and the patient has not abandoned the treatment early. The generalization of the results is limited due to the inclusion of other types of studies jointly with randomized controlled trials and the variability among the samples of the studies. In conclusion, family and patient communication interventions have shown a positive effect on preventing a second suicide attempt. More studies are needed to investigate the effectiveness of different prevention approaches at hand and clarify in which patient populations each intervention could be more effective.