Reducing suicide attempts with a compounded Brief Contact Intervention: a nationwide study of the VigilanS project, France

BackgroundSuicide prevention has become a global public health priority, and Brief Contact Interventions (BCI) following suicide attempts (SA) are an important tool for preventing suicides. The VigilanS project was designed to generalize compounded BCIs at the entire population level., It involves resource cards, telephone calls, and mailings, following a predefined algorithm. It has been implemented progressively in France, on a region-by-region basis, since 2015. ObjectiveTo evaluate the effectiveness of VigilanS in reducing suicide attempts among patients aged 18 years and older, and to explore potential differences in effectiveness by sex, age, and geographical location. MethodsThe study used data from the French national hospitalization database, PMSI-MCO. It included all patients over age 18 who were admitted to general hospitals for suicide attempts, between 2012 and 2022. Time-to-event ("survival") analysis of a second SA after a first one was performed; patients whose first SA occurred before VigilanS implementation were compared with their after-VigilanS counterparts. Six regions, with implementation occurring between 2015 and 2017, are analyzed here. ResultsThe differences in distribution of time-to-new-SA among patients before and after VigilanS implementation were statistically significant in all six regions under scope (log-rank test: P<0.0001). The Cox regression analysis revealed that VigilanS was significantly associated with a reduced risk of reattempting suicide in all regions. Age consistently showed a negative association with reattempting suicide. ConclusionVigilanS is likely effective in reducing suicide attempts among patients aged 18 years and older in France. This suggests that implementing BCIs following SAs in general hospitals at a population-wide level can contribute to reducing suicide rates and provides real-world evidence (RWE).