How the study worked

The study started as a systematic review and meta-analysis conducted of controlled studies evaluating suicide prevention interventions versus control published between 2011 and 2017 in PubMed, PsycoINFO and Cochrane databases.

Following the Review, the team developed a study protocol to implement a regional suicide prevention systems intervention and evaluated by a stepped wedge trial design in five specialist mental health institutions and their adherent chain partners.

The system intervention is called SUPREMOCOL, which stands for Suicide Prevention by Monitoring and Collaborative Care, and focuses on four pillars:

recognition of people at risk for suicide by the development and implementation of a monitoring system with decision aid,
swift access to specialist care of people at risk,
positioning nurse care managers for collaborative care case management, and
12 months telephone follow up.

Eligible patients were persons attempting suicide or expressing suicidal ideation. Primary outcome was number of completed suicides, as reported by Statistics Netherlands and regional Public Health Institutes. The project ran from 2016 until 2021.