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. Author manuscript; available in PMC: 2011 Jun 1.
Published in final edited form as: Ann Emerg Med. 2010 Apr 9;56(6):649–659. doi: 10.1016/j.annemergmed.2010.02.026

Table 4.

ED + post-ED interventions

First Author Intervention (I) and Key Features Comparison (C) Primary Outcome and Measurement (time point) Results (I vs. C) Interpretation
Experimental Studies
Fleischmann31 Standard care plus Brief Intervention and Contact (BIC)

BIC Features:
- Information post-discharge on risk and protective factors, basic epidemiology, alternative behaviors and referral options
- Nine follow-up contacts (telephone or in-person)		 Standard Care

Features:
- Treatment of somatic symptoms		 Death by suicide at 18 months follow-up RR=0.10 (95%CI:0.03,0.41)

NNT=52 (range:32, 98)		 Brief intervention with ongoing supportive contact can reduce the likelihood of mortality attributable to suicide across the lifespan.
Quasi-Experimental Studies
Rotheram- Borus34 Specialized ED care plus SNAP (Successful Negotiation Acting Positively) therapy

Features:
- Psychiatric evaluation
- Referral to SNAP therapy
- Crisis therapy session
- Video viewing

SNAP: 6 outpatient sessions that focused on role-playing, problem-solving, negotiation		 Standard ED care plus SNAP therapy

Features:
- Psychiatric evaluation
- Referral to SNAP therapy		 Treatment completion and suicide re-attempts at 18 months Treatment completion
OR=2.78 (95%CI:1.20,6.67)

NNT=5 (range:3,20)

Suicide re-attempts
RR=0.63 (95%CI:0.25,1.54)		 Specialized ED care for youths increases the likelihood of treatment completion, but does not significantly reduce the risk of suicide re- attempt.
Greenfield36 Rapid response outpatient team

Features:
- Part-time psychiatrist and psychiatric nurse contacted patient immediately after assessment in ED to schedule follow-up appointment, and team provided care until long- term arrangements could be made in the community		 Standard Care

Features:
- Psychiatrist in the ED could hospitalize the patient, follow the patient as an outpatient, or refer the patient to community- based resources		 Suicide-related hospitalization at 6 months follow-up RR=0.41 (95%CI:0.28,0.60)

NNT=4 (range:3,7)		 A rapid response outpatient model can reduce subsequent suicide-related hospitalizations for youths.