Structured Disposition Planning for Adolescent Suicide Attempters in a General Hospital: Preliminary Findings on Short-Term Outcome

Adolescent suicide attempters are often noncompliant with outpatient psychotherapy and drop out of treatment much more quickly than non-suicidaladolescents. In this study, 23 adolescents received medical treatment and astandard psychiatric evaluation in an Emergency Department following asuicide attempt. In addition, all subjects and their parents received apsychotherapy compliance enhancement intervention which included a verbalagreement between the adolescent and parent/guardian to attend at least fourpsychotherapy sessions. After discharge from the hospital, each subjectreceived three phone interviews over an 8 week period using a problemsolving approach around two key areas: suicidal ideation and psychotherapycompliance. Compared to a three month follow-up of 78 subjects (which didnot include an experimental intervention), conducted at the same hospital,the experimental intervention resulted in fewer outpatient psychotherapy ’noshows‘ (9% vs. 18%) and a trend toward greater number ofsessions attended (5.5 vs. 3.9). There were no re-attempts in theexperimental group as compared to 9% in the comparison group. Resultsare promising and a randomized intervention trial appears indicated.