Structured disposition planning for adolescent suicide attempters in a general hospital: Preliminary findings on short-term outcome

Abstract

Adolescent suicide attempters are often noncompliant with outpatient psychotherapy and drop out of treatment much more quickly than non-suicidal adolescents. In this study, 23 adolescents received medical treatment and a standard psychiatric evaluation in an Emergency Department following a suicide attempt. In addition, all subjects and their parents received a psychotherapy compliance enhancement intervention which included a verbal agreement between the adolescent and parent/guardian to attend at least four psychotherapy sessions. After discharge from the hospital, each subject received three phone interviews over an 8 week period using a problem solving approach around two key areas: suicidal ideation and psychotherapy compliance. Compared to a three month follow-up of 78 subjects (which did not include an experimental intervention), conducted at the same hospital, the experimental intervention resulted in fewer outpatient psychotherapy ‘no shows' (9% vs. 18%) and a trend toward greater number of sessions attended (5.5 vs. 3.9). There were no re-attempts in the experimental group as compared to 9% in the comparison group. Results are promising and a randomized intervention trial appears indicated.