Suicide Prevention Algorithm in the French Overseas Territories

Not Applicable

Completed

• Conditions: Suicide Attempt
• Interventions: Other: APSOM vs Control

• Registration Number: NCT03427190
• Lead Sponsor: University Hospital Center of Martinique

Brief Summary

In France, suicide behaviours are a major public health concern that triggered the creation in 2013 of a National Observatory of Suicide. In continental France, the "Algos" protocol was found to be effective for the prevention of suicide attempts reiterations. This protocol is based on a procedure that keeps telephone and postal contacts with the suicide attempter and allows, via an algorithm, to assess the risk of suicide attempt recurrence, in order to intervene if necessary. Nevertheless, Algos does not involve primary care health practitioners, who could add a substantial additional efficacy, especially if they intervene downstream and in supplement to Algos. In addition, this kind of protocol has never been evaluated in the French overseas territories.

Detailed Description

Since (1) Algos was never implemented in the French overseas departments (FOD) and does not involve primary care practitioners (PCP), (2) the additional effect of PCP involvement over and beyond Algos alone in unknown, and (3) little research on suicide behaviours has been conducted in the FOD, this proposal has the following main aim: to assess the effectiveness and the efficacy of the intervention, in supplement and downstream to Algos, of a healthcare professional, on the recurrence of suicide attempts in the FOD; the healthcare professional will be the patient's general practitioner, whenever possible.

Study Timeline

• Study First Submitted: 2017-01-30
• Study Start: 2017-10-09
• Study First Submitted QC: 2018-02-02
• Study First Posted: 2018-02-09
• Primary Completion: 2019-08-08
• Status Verified: 2020-10
• Study Completion: 2020-10-16
• Last Update Submitted: 2021-01-26
• Last Update Posted: 2021-01-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 259

Inclusion Criteria

• Man or woman over 16 years of age
• Leaving the hospital within 15 days of the suicide attempt
• Giving (him/herself or his/her legal representative)an oral consent to participate in the study
• Having healthcare insurance
• Reachable by phone, with possibility of confidential conversation, and by mail
• Resident of Guadeloupe, French Guyana, Martinique, or Reunion Island
• Able to understand and speak French

Exclusion Criteria

• Homeless person
• Disabled adult, person under judicial/court protection, legally incompetent adult
• Participant unable to understand the study protocol, its risks and side effects, or declining to participate

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control	APSOM vs Control	Phone contact with patient will be made by a professional psychologist within 21 days of hospital discharge. If contact cannot be made after 9 attempts, post-cards will be sent monthly at M2, M3, M4 and M5, asking the participant to establish contact with the designated psychologist. The phone call will determine whether or not the participant is in a state of suicidal crisis. If yes, steps will be taken to attend the crisis within 24 hours.
APSOM	APSOM vs Control	In complement to actions described in the control arm, the patient's general practitioner (GP) and the patient him/herself will be contacted within 21 days of hospital discharge in order to organize an appointment between them two; this consultation is expected to take place between day 22 and day 45 after hospital discharge. If the patient does not have a GP, a health-care professional (HCP) will be provided. .GP (or HCP) will also be contacted at 6 and 13 months.

Primary Outcome Measures

Name	Time	Method
Existence of a suicide	13 months	Reiteration of suicidal attempt after hospital discharge

Secondary Outcome Measures

Name	Time	Method
Number of suicide attempts	6 and 13 months after hospital discharge	To know total number of suicide
Number of deaths by suicide	6 and 13 months after hospital discharge	To know number of deaths by suicide
Scores at the Hospital Anxiety and Depression Scale (HADS)	6 and 13 months after hospital discharge	Pass the scale HADS
Assessment of suicidal risk by the Sad Persons Scale and the Columbia Suicide Severity Rating Scale (C-SSRS).	6 and 13 months after hospital discharge	Pass the scale Columbia

Trial Locations

Locations (9)

CH Ouest Guyanais; 🇬🇫 Saint-Laurent du Maroni, French Guiana

CHU de Pointe à Pitre; 🇬🇵 Les Abymes, Guadeloupe

CHU Martinique; 🇲🇶 Fort-de-France, Martinique

Centre d'Accueil d'Urgences Médico-Psychologique; 🇷🇪 Saint-Pierre, Réunion

CH de Cayenne; 🇬🇫 Cayenne, French Guiana

Etablissement Psychiatrique de Santé Mentale; 🇷🇪 Saint-Benoit, Réunion

CH de Monteran; 🇬🇵 Saint-claude, Guadeloupe

Centre d'Accueil Psychiatrique Nord; 🇷🇪 Saint-denis, Réunion

Centre d'Accueil Psychiatrique Ouest-Centre; 🇷🇪 Saint-Paul, Réunion