A Randomized Controlled Multicenter Trial of Post-Suicide Attempt Case Management for the Prevention of Further Attempts in Japan (ACTION-J)

• Any cause of death [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: Yes ]
• Number and rates of repeated recurrent incidence of suicide attempts [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: Yes ]
• Utilization or personal or social resources [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: No ]
• Number of self-injury [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: Yes ]
• Health care utilization [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: No ]
• Physical function [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: Yes ]
• Beck hopeless scale [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: No ]
• SF-36 [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: No ]
• Adverse events [ Time Frame: Minimum 1.5 year ] [ Designated as safety issue: Yes ]

This study will determine the effectiveness of continuous follow-up care by case manager in preventing further suicide attempts

It is well known that many subjects who survived a suicide attempt will make further suicide attempts, even after the medical treatment at critical emergency unit. To examine the effectiveness of continuous follow-up care by case manager after the suicide attempt, a randomized, controlled, multicenter trial by J-MISP (Japanese Multimodal Intervention Trials).This research project is one of the strategic research projects funded by The Japanese Ministry of Health, Labor and Welfare. In this study, J-MISP will implement the intervention for suicide attempters, a considerably high-risk group of further suicide attempts, who are transported by emergency services.

• Behavioral: Case management
  Case management, Usual clinical practice and Providing paper based information for suicide prevention
• Other: Treatment as usual
  Usual clinical practice and Providing paper based information for suicide prevention

• Experimental: 1
  Intervention: Behavioral: Case management
• Active Comparator: 2
  Intervention: Other: Treatment as usual

• Hirayasu Y, Kawanishi C, Yonemoto N, Ishizuka N, Okubo Y, Sakai A, Kishimoto T, Miyaoka H, Otsuka K, Kamijo Y, Matsuoka Y, Aruga T. A randomized controlled multicenter trial of post-suicide attempt case management for the prevention of further attempts in Japan (ACTION-J). BMC Public Health. 2009 Sep 26;9:364.
• Kawanishi C, Hirayasu Y, Ariga T, Ishizuka N, Yamada M, Takahashi K. ["ACTION-J", a multi-center joint study for the development of strategies to prevent recurrence of suicidal ideation (a strategic study for anti-suicide policies supported by the Health, Labor and Welfare Ministry): its background and research outline] Seishin Shinkeigaku Zasshi. 2008;110(3):230-7. Japanese. No abstract available.

Inclusion Criteria:

1. Over 20 years old
2. Suffering from Axis I disorder
3. Had intent for suicide (confirmed more than 2 times)
4. Able to understand this study and provide informed consent
5. Able to have interview before trial registry and psycho education at hospital
6. Able to have interview for assessment at continuous follow-up care by case manager at the hospital

Exclusion Criteria:

1. Not suffering from Axis I disorder as a primary diagnosis