Table 3.

Post-ED interventions (direct ED enrolment)

First Author	Intervention (I) and Key Features	Comparison (C)	Primary Outcome and Measurement (time point)	Results (I vs. C)	Interpretation
Experimental Studies
Donaldson28	Skills-based Treatment (SBT) Features: - Problem-solving - Affect management skills - 9 individual sessions, 1–3 family sessions, plus 2 optional crisis sessions	Supportive relationship treatment (Standard Care) Features: - Focus on mood, behaviors and factors that contribute to suicide- related behaviors - 9 individual sessions, 1- 3 family sessions, plus 2 optional crisis sessions	Cumulative rates of suicide re-attempts and suicidal ideation± at 6 months follow-up	Rates of re-attempt RR=2.13 (95%CI:0.53,9.08) Suicidal ideation MD=-7.27 (95%CI:−35.13,20.59)	Treatment designed to address skill deficits in youths does not reduce rates of suicide re- attempt or suicidal ideation.
Tyrer32	Manual Assisted Cognitive Behavior Therapy (MACT) Features: - Up to seven treatment sessions with a therapist trained in MACT methods were offered and a manual illustrating management strategies was provided	Treatment As Usual Features: - Patient seen by a therapist and was offered the standard treatment or the continuation of existing therapy	Recurrent self-harm episodes at 1 year follow-up	RR=0.86 (95%CI:0.69,1.08)	Manual Assisted Cognitive Behavior Therapy does not reduce the likelihood of repeat episodes of self-harm across the lifespan.
van Heeringen30	Home Visits Features: - Community nurse evaluated treatment needs and matches to available community services - 1–2 contacts in < 1month	Standard Care Features: - Referral without home visits	Adherence with referral at 7 days follow-up	RR=1.28 (95%CI:1.06,1.56) NNT=9 (range:6,38)	Home visits by a community nurse increase the likelihood of adherence with referral in youths and adults.
McLeavey33	Interpersonal problem-solving skills training Features: - Five weekly sessions were given with training in five general stages of problem solving, with a supplementary manual and homework assignments	Brief problem-oriented treatment Features: - Patient seen by a therapist within 2 weeks of discharge from ED and received treatment focused on resolution or reduction of current problems	Recurrent self-harm (self-poisoning) at 1 year follow-up†	RR=0.50 (95%CI:0.12,2.05)	Interpersonal problem- solving skills training does not significantly reduce the likelihood of self-poisoning in the year following the index event.
Waterhouse29	Hospital admission Features: - Admission with recommendation to contact family physician if in need of further help	Discharge home Features: - Recommendation to contact family physician if in need of further help	Repeat ED presentations for self-harm at 16 weeks follow-up	RR=0.77 (95%CI:0.20,2.89)	Hospital admission of youth and adult patients with suicide-related behaviors does not decrease the likelihood of ED re-presentation following discharge.
Quasi-Experimental Studies
Deykin35	Specialized direct service Features: - Community-based outreach program providing support, a liaison with the hospital, and advocacy with relevant agencies - Unreported number of contacts	Standard Care Features: - not described	Repeat ED presentations for suicide attempt or self-harm at 24 months follow-up	RR=1.71 (95%CI:0.73,4.03)	Specialized direct service for youths does not reduce the likelihood of ED re-presentation for suicide attempt.

^±Measured using the Suicidal Ideation Questionnaire (SIQ)

^†Analysis with treatment completers only