Effectiveness of assertive case management for patients with suicidal intent

IntroductionSuicide attempt is the most important risk factor for later suicide. A randomised-controlled, multicentre trial of postsuicide attempt case management for the prevention of further suicide attempts in Japan, named ACTION-J, has established effective interventions for prevention of suicide reattempts. The ACTION-J assertive case management intervention programme was adopted by the Japanese Ministry of Health, Labour and Welfare in 2016, when medical fees were revised. This nationwide programme is provided to patients who attempt suicide and who are admitted to emergency departments in Japan.The aim of the present study is to examine the current implementation status of the ACTION-J programme. The present study also aims to clarify which patients’ and hospitals’ factors affect the implementation of the programme.Methods and analysisThis is a prospective, multicentre, patient registry cohort study. Participants will be suicide attempters admitted to the emergency departments of medical facilities with both psychiatry and emergency departments. The assertive case management programme will be delivered to participants by a case manager for up to 24 weeks, based on psychiatric diagnoses, social risks and patient needs. The core feature of the programme is to encourage patients to participate in psychiatric treatment.The primary outcome will be the proportion of patients still participating in the case management intervention at 24 weeks after registration. The secondary outcomes will include measures of the fidelity of the case management intervention. The fidelity will be evaluated using a fidelity assessment manual developed by the study group.Ethics and disseminationThis observational study has been approved by the ethics board of Sapporo Medical University. Enrolment began in October 2016 and will continue until December 2018. Dissemination plans include presentations at scientific conferences and scientific publications.Trial registrationUMIN000024474.

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Combining social skills training and assertive case management: The social and independent living skills program of the brentwood veterans affairs medical center

New Directions for Mental Health Services ◽

10.1002/yd.23319925305 ◽

1992 ◽

Vol 1992 (53) ◽

pp. 33-42 ◽

Cited By ~ 7

Author(s):

Jerome V. Vaccaro ◽

Robert P. Liberman ◽

Charles J. Wallace ◽

Gayla Blackwell

Keyword(s):

Case Management ◽

Independent Living ◽

Social Skills Training ◽

Medical Center ◽

Skills Training ◽

Veterans Affairs ◽

Independent Living Skills ◽

The Social ◽

Living Skills ◽

Assertive Case Management

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Measuring Disability, Need and Outcome in Australian Community Mental Health Services

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2000.00815.x ◽

2000 ◽

Vol 34 (5) ◽

pp. 850-855 ◽

Cited By ~ 21

Author(s):

Jill Gallagher ◽

Maree Teesson

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Case Management ◽

Community Mental Health Services ◽

Standard Case ◽

Australian Community ◽

Standard Case Management ◽

Assertive Case Management

Objective: This study trialled routine measurement of disability, need and outcome in mental health services within Sydney. Method: Fifteen community mental health clinicians with a combined caseload of 283 patients participated in the study. The Health of the Nation Outcome Scales (HoNOS) was used to assess disability and outcome and the patient and staff versions of the Camberwell Assessment of Need (CAN) were used to assess need. Results: The HoNOS and CAN appear to be promising contenders for routine use. Patients receiving assertive case management were rated as having higher levels of disability and need than patients receiving standard case management. Significant change in outcome was demonstrated with the HoNOS. Conclusions: To ensure the continued measurement of consumer outcome, issues such as staff education, training, and the development of computerised information systems should be addressed.

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Preventing Self-harm and Reducing Suicidal Ideation Through an Expedited Regular Supportive Psychotherapy and assertive Case Management – Protocol for a Three-arm Partial Randomised Controlled Trial

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1599 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S440-S440 ◽

Cited By ~ 1

Author(s):

V. agyapong ◽

T. Behre ◽

M. Juhas ◽

a. Greenshaw

Keyword(s):

Suicidal Ideation ◽

Case Management ◽

Controlled Trial ◽

Intervention Group ◽

Supportive Psychotherapy ◽

Assertive Outreach ◽

Management Protocol ◽

Self Harm ◽

Randomised Controlled ◽

Assertive Case Management

aimTo conduct a three-arm partial randomised controlled trail to evaluate the effectiveness of expedited regular supportive psychotherapy and assertive case management for patients presenting with suicidal ideation or self-harm to the emergency department (ED).Hypothesiswe expect expedited regular supportive psychotherapy plus assertive case management will reduce the suicidality and/or suicidal behaviour in patients by at least 20% at 4 weeks compared to patients receiving only assertive case management or routine care and these differences will be sustained at 6 months.MethodsThis will be a longitudinal, prospective, three-arm controlled single-rater-blinded partial randomized clinical trial with a recruitment period of 12 months and an observation period of 6 months for each participant. Patients in the intervention group will receive regular face-to-face or over the phone brief supportive psychotherapy during weekdays following presentation to the ED with suicidal ideation or self-harm until patients are actively enrolled in regular community mental health services with active case management by the therapist. Patients in the control and the assertive outreach arms will each receive the usual follow-up services offered routinely to regular patients and assertive outreach patients respectively who present to the ED with suicidal ideation or self-harm.ResultsRecruitment will commence in February 2016 and we expect the results of the study to be available by September 2017.ConclusionIf our hypothesis is proved correct, our intervention will be a new model for caring for patients with self-harm and suicidal ideation and is expected to reduce suicide rates.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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