Impact of a High-resolution Program for the Prevention of Suicidal Behavior in At-risk Adults: a Quasi-experimental Ambispective Cohort Study

Summary

Background: Suicidal behavior represents a major public health problem worldwide. According to the World Health Organization (WHO), approximately 720.000 people die by suicide annually, and many more attempt it. Suicide is a personal tragedy associated with extreme suffering that has a serious impact on the deceased's immediate circle and on society as a whole. In this context, there is an urgent need to design effective and humane intervention strategies that offer an evidence-based, preventive, specialized, and community-oriented response to suicidal behavior.

Objective: To evaluate the impact of a multidisciplinary, specialized, and high-resolution program for the prevention of suicidal behavior in adults aged 18 and over in the Salamanca Health Area.

Methods: A quasi-experimental, ambispective cohort study with two parallel groups: an intervention group, receiving the specific suicide prevention program (SPP) with a pre-test/post-test design, and a control group, receiving usual care (TC). Adult patients (≥ 18 years) will be referred from the Emergency Department of the University Hospital of Salamanca after an initial psychiatric evaluation. Patients will be assigned to the intervention group according to established inclusion criteria. The program lasts 3 months, during which each participant will receive intensive and individualized follow-up from a multidisciplinary team composed of two psychiatrists, two mental health nurses, two psychologists, and two social workers at two community mental health centers. Participants will also attend 10 weekly group therapy sessions. Follow-up evaluations will be conducted at the end of the program (three months) and six months after the first contact.

Discussion: This study will contribute to the scientific evidence base on the effectiveness of intensive and specific suicide prevention programs in the community setting, optimizing healthcare resources, improving treatment adherence, and aligning with the Spanish National Suicide Prevention Plan 2025-2027. Ethics and dissemination: This study has been approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm code: PI 2025 11 2102 - TD)

Keywords: Suicidal behavior; Suicide prevention; Suicidal ideation; Community mental health services; Quasi-experimental study; Cohort study; Psychiatric emergency services; Patient care team.

Conditions

• Prevention of Suicidal Behavior

Interventions

BEHAVIORAL

PPS; SUICIDE PREVENTION PROGRAM

The Suicide Prevention Program (PPS) is a high-resolution, outpatient program delivered by a multidisciplinary team consisting of two mental health nurses, two psychiatrists, two psychologists, and two social workers. It operates in two community mental health centers in Salamanca, belonging to the Specialized Care Management, over a three-month period. The first contact with the patient will be made by telephone within 24 hours of referral by a mental health nurse. The first in-person appointment will take place in a nursing consultation within 72 hours. The patient will have a maximum of 72 psychiatric appointments, a maximum of seven days for the first appointment with a psychologist, and a maximum of 14 days for the first appointment with a social worker. The program also includes 10 group sessions, in-person and telephone follow-up, and crisis intervention.

Sponsors & Collaborators

• Sanidad de Castilla y León

  collaborator OTHER

• University of Salamanca

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-05-01

Primary Completion

2026-05-01

Completion

2027-05-31

Countries

• Spain

Study Locations