Conference Agenda

Background: Follow-up care after discharge from admissions is broadly recommended in clinical guidelines for suicide prevention. Still, little is known about service and patient characteristics associated with follow-up care for patients who later die by suicide.

Objective: To identify features associated with not receiving follow-up care after discharge for patients who die by suicide within one year of their last admission.

Methods: Hybrid registry study with data from national administrative registries and a clinical questionnaire for 620 individuals who died by suicide within one year after discharge from admission between 1.1.2018 and 31.12.2022. Gradient boosting was used to identify key features associated with receiving follow-up care after discharge and Shapley additive explanation values to explain the model.

Findings: 43% of patients did not recieve follow-up. 86% of first appointments occurred within 30 days. Area Under the Curve for the boosting model was 0.80 (95% CI: 0.78 – 0.82). The most important features associated with not receiving follow-up were: Patient's family was aware of the discharge (Shap = 0.928), age above 40 (Shap = 0.243), short last admission (Shap = 0.223), and depressive symptoms not reported at the last contact (Shap = 0.169).

Conclusions and implications: Approximately half of patients in this population did not receive follow-up care. New follow-up appointments after the first 30 days were rare, indicating substantial missed opportunities for suicide prevention during this key risk period. The features associated with non-receipt of follow up indicate difficulties engaging patients in collaborative care, and that special attention be warranted for older patients, those without depressive symptoms at discharge, and after short admissions. Increasing follow-up will likely entail both better implementation of existing interventions and exploring new forms of follow-up that are effective, scalable, and importantly: that could be acceptable to a larger proportion of these patients.

The period immediately following discharge from psychiatric inpatient care is associated with a markedly elevated risk of suicide. The CLASP program was designed by Miller, Gaudiano & Weinstock as a transitional, post-hospital intervention to maintain continuity of care for patients after a suicide attempt and to actively involve close others in the recovery process. This presentation focuses on how patients and their close others experience participation in the CLASP program and how they perceive its role in providing support and safety in everyday life after hospital discharge.

The study was conducted between September and December 2025 using a qualitative approach based on individual in-depth interviews with CLASP participants from three Mental Health Centers in Poland involved in the pilot implementation of the program. Eighteen interviews were carried out with patients (n = 12) and close others (n = 6). The interviews were analyzed thematically, with particular attention to experiences related to support, safety, and coping in the post-discharge period.

Participants consistently described CLASP as a source of reassurance, continuity, and the sense that “someone is there” during a time of heightened vulnerability. Regular contact with a clinician, individualized safety planning, and monitoring of early warning signs were perceived as key components of the program. CLASP was often experienced as a buffer between inpatient treatment and subsequent outpatient care. The perceived impact on suicidal ideation varied, with participants emphasizing both changes in suicidal thoughts and greater preparedness to manage crisis situations. Close others highlighted improved communication, increased awareness of warning signs, and feeling more supported themselves.

Importantly, the presentation will also address key limitations emerging from participants’ accounts, as well as broader challenges related to implementing CLASP—an intervention originally developed in the United States—within a different organizational and socio-cultural context.

Suicide risk of psychiatric patients has proven to be significantly increased in the months after discharge from a psychiatric hospital. Despite this high risk there is a lack of systematic research on the causes of this elevated suicide risk as well as a lack of treatment and intervention for patients at high risk after discharge. The main objectives of this pilot study were, firstly, to examine the factors contributing to the elevated suicide risk, and secondly, to analyse whether an additional setting of care starting at discharge may reduce suicidality.

In this multi-centre pilot study, treatment as usual was complemented by an additional 18-months post-discharge setting of care. Two groups of patients differing in the amount of post-discharge personal contacts were compared. One group of patients was offered continuous personal contacts after discharge (months 1-6: monthly contacts; months 6-18: every two months) while another group of patients received contacts only at months 6, 12, and 18 after discharge. Data on suicidality as well as relevant other symptoms, psychopathology, treatment and important events were collected. In case of serious health-related events, the setting of care allowed to connect with the doctor or therapist treating the patient.

210 persons were included in the PSSP-study. There were no suicides verifiable, in both groups of the study suicide attempts were only singular events. The statistically recorded suicidality showed no significantly different results for both groups of the study and was comparatively low considering the risk of the group in general.

Relevant findings regarding the Sheehan Suicidality Tracking Scale (S-STS) scores and the MADRS scores at baseline and their associations with suicidality are discussed. Certain critical factors raising suicidality are emphasized and protective aspects of a setting of care with regular personal contacts after discharge from inpatient psychiatric treatment are presented.

The development and evaluation of low-intensity public health interventions aimed at reducing suicide and suicidal behaviors has been identified as a critical next step in suicide prevention research. Brief Contact Interventions (BCIs) demonstrate potential as effective, wide-reaching, and scalable approaches that can be more easily disseminated to the public. This project evaluates the feasibility and explores the underlying mechanisms of Follow-up conversations, a telephone-based BCI being piloted for the first time in a Swedish context. The intervention being evaluated is novel as it is being implemented by a non-profit/non-governemental organization and consists of eight follow-up calls delivered over a 12-month period. The evaluation plan was developed concurrently with the intervention, enabling the evaluation team to capture early lessons learned in real time. The evaluation is grounded in the FRAME-IT(S) framework (Feasibility, Reach Out, Acceptability, Maintenance, Implementation Tailorability, and Scalability) and includes analysis of aggregate and individual-level process data, participant surveys, and semi-structured interviews with participants and stakeholders. Two groups of stakeholders have been identified as being involved in implementation: employees and volunteers the Swedish non-profit delivering the intervention and employees at connecting organizations responsible for identifying and referring potential participants. Connecting organizations include social services and emergency services one urban and one rural region of Sweden. The pilot is ongoing, and results are expected in 2026. Early lessons highlight the importance of strong evaluator–stakeholder partnerships, awareness of legal and organizational constraints and the central role of connecting organizations in participant identification and engagement. Additionally, preliminary results of interviews with stakeholders and participants will be presented. The evaluation results will inform improvements to the intervention, assess its scalability, contribute to the understanding of the mechanisms underpinning BCIs and support the design of a planned randomized controlled trial to evaluate effectiveness preventing suicidal behaviors.

Estimating the number of suicides deaths prevented through psychosocial therapy provided in the Danish Suicide Prevention Clinics

Background

Psychosocial therapy is recommended for individuals at risk of suicide. The psychosocial therapy provided in the Danish Suicide Prevention Clinics has been linked to lower risks of suicide on short and long terms. However, it remains to be evaluated how many suicide deaths are actually prevented by this treatment. The aim of this project was to estimate the yearly number of prevented suicide deaths, which may be attributed to the psychosocial therapy provided in the Danish Suicide Prevention Clinics.

Methods

Individual-level data on patients attending treatment in the Danish Suicide Prevention Clinics during 1992-2024 were analyzed. We assumed comparable treatment effects for patients with suicidal ideation as for those with suicide attempts and calculated the number of observed person-years in intervals of 1, 5, 10 and 20 years after treatment. Suicide rates were calculated using 23 established factors and used to estimate the number of prevented suicide deaths.

Results

Yearly, between 1,250 and 2,500 patients were treated in the Danish Suicide Prevention Clinics over the past 20 years, approximating 500,000 person-years of up to 20 years of follow-up. Taking account of long-term effects, it is estimated that approximately 15-20 suicide deaths were prevented on a yearly basis, accumulating to more than 350 suicide deaths since 1992. The final results of the analyses will be available at the time of the conference.

Conclusions

Being able to quantify the number of prevented suicide deaths for specific interventions provides important information for planning national suicide prevention strategies. The data from this study suggest that providing treatment to at-risk patients yielded promising outcomes in terms of saved lives.

Background: General practitioners (GPs) have frequent interactions and continuous relations with their patients and therefore hold a key position in suicide prevention. Previous studies identified lack of training in suicide prevention as a barrier for GPs, which potentially could have serious consequences for patients at risk of suicide.

Objective: This study explored how GPs in Denmark manage patients at risk of suicidal behaviour. Specifically, we investigated GPs’ knowledge and experience with i) treatment of patients at risk of suicide ii) adherence to guidelines and iii) collaboration with relevant stakeholders. Additionally, we explored iv) their perception of possible areas of improvement.

Methods: This was a qualitative study with in-depth, semi-structured interviews. Eight GPs from different municipalities in the Region of Southern Denmark were recruited between December 2024 and January 2025. Data were collected through online interviews, and a reflexive thematic analysis was applied.

Key results: Four themes were generated; i) educational preparedness, ii) collaboration with stakeholders, iii) therapeutic relationship, and iv) suggested changes. Most of the included GPs experienced themselves as being well-educated in suicide prevention and were confident talking to patients at risk. Challenges often arose in the collaboration with external stakeholders such as psychiatric services or the municipality due to rejected referrals or lacking communication. Useful information on specific help services was difficult to find. Updated practices with incorporation of supporting phrases, easier referral pathways to psychiatric services and access to guidelines could be targets of future improvements.

Conclusions: Danish GPs were generally well-trained and confident in addressing suicidal behaviour, while suicide prevention in primary care can be strengthened through cross sectoral collaboration and coherence.