Psychosocial interventions following self-harm: systematic review of their efficacy in preventing suicide

BACKGROUND: With almost a million people dying by suicide worldwide each year, reducing the rate of suicidal behaviour is a priority in many countries.AIMS: To examine whether additional psychosocial interventions following an episode of self-harm reduce the likelihood of subsequent suicide. METHOD: We conducted a systematic review and meta-analysis of data from randomised controlled trials of interventions for people following self-harm. Likelihood of suicide was compared by calculating the pooled root difference in suicide rate with 95% confidence intervals. RESULTS: We obtained suicide data from 18 studies with a total population of 3918. Eighteen suicides occurred among people offered active treatment and 19 among those offered standard care (pooled root difference in suicide rate 0.0,95% CI -0.03 to 0.03). The overall rate of suicide among people participating in trials was similar to that reported in observational studies of people who self-harm. CONCLUSIONS: Results of this meta-analysis do not provide evidence that additional psychosocial interventions following self-harm have a marked effect on the likelihood of subsequent suicide.