following attempted suicide
In spite of the recent decrease in deliberate self-poisoning and self-injury in the United Kingdom ( Brewer and Farmer, 1985; Platt et al., 1988), rates of this behaviour are still very high, and self-poisoning remains the most common reason for acute medical admission of women to general hospitals and the second most common reason for such admissions of men ( Hawton and Catalan, 1987). The importance of careful assessment of suicide attempters in the general hospital is unquestionable. However, there is little consensus about what might be the best policies for after-care of patients who do not require psychiatric hospital admission. For example, the proportions of patients offered out-patient care vary considerably between different clinical services (e.g. Platt et al., 1988). Furthermore, there is no general agreement about which treatment approaches for such patients are most appropriate.
The reasons for this situation are, in part, the dearth of controlled studies of treatment of these patients and, as will be shown, the somewhat disappointing results of the few studies which have been conducted. This chapter presents a review of the prospective randomised controlled treatment studies of attempted suicide patients which have been carried out in the United Kingdom. Only studies of primarily psychosocial intervention are included, not studies solely of the use of medication. In addition to drawing conclusions from the findings of these studies, the problems inherent in such investigations will also be examined. Finally, suggestions will be made about how future treatment studies of attempted suicide patients might be conducted.
Four studies meeting the criteria noted above have been carried out and reported in the literature. The first of these was