A new research study suggests that something as simple as regular, personalized letters following a short term of therapy can help individuals at risk of repeating an attempt at suicide. Swiss researchers tested the Attempted Suicide Short Intervention Program (ASSIP) with approximately 120 people who had been hospitalized after attempting suicide.
The patients were divided into a control group receiving standard treatment (in-patient and out-patient) and an ASSIP group with standard treatment plus three strategic therapy sessions followed by six letters from their therapists over the next two years. The results were striking: While each group had one completed suicide, there were five repeat suicide attempts in the ASSIP group compared to 41 attempts in the control group. ASSIP participants also spent 72% fewer days in the hospital during follow-up. The research was published in PLOS Medicine, and highlighted this week by the Huffington Post and Washington Post.
When I shared the Huff Post story with Forefront’s master trainer Sue Eastgard, she called the findings “so simple and so profound,” and noted that this study basically repeats one done 15-20 years ago. “Caring Letters have been demonstrated to be one of the most effective suicide prevention interventions,” she said.
It makes me wonder why this approach is not used more routinely. It’s economical and easy to replicate — the Swiss study was based on a published manual. It provides an ongoing connection and regular reminders of coping strategies and additional resources.
Like most researchers, the Swiss authors shared some with reservations, primarily the need for more studies with larger populations. One such clinical trial is starting this year in U.S. military and veterans affairs health care systems. It will test the use of follow-up emails, rather than letters. The U.S. research team seems enthusiastic about the benefits already shown by caring contacts, notably the intervention’s “simplicity and portability” and its basis in “the notion that even the most basic expression of care and compassion for others can have a powerful, live-saving influence.”
That’s a great reminder for all of us. Even an occasional caring note of hope and support could make a big difference to someone struggling with depression or suicidal thoughts.