Drawing on the peer-review literature, a summary of the current evidence/best practice related to indicated approaches is provided below.
Summary of current evidence/best practice 69,70,71,72
There is promising evidence that improving support for people after suicide attempts may be an effective indicated strategy. Interventions include improving access to and coordination of mental health services.There is some evidence that pharmacotherapy for mental illness as an indicated approach may reduce suicidal behaviour, despite controversies surrounding potential adverse effects of some classes of medication.
For people with mental illness, psychotherapy and psychosocial interventions have also been shown to be appropriate indicated approaches. In some studies these interventions have demonstrated a reduction in suicidal behaviour, either alone or in combination with medication.
Findings in relation to NSPP-funded activities
As indicated in Section 6.4.12, the NSPP-funded projects received referrals from, and made referrals to, a wide range of other organisations. Several projects aimed to improve access to care and support pathways for people following suicide attempts (for example, by improving transition from the emergency department to primary care or community mental health services).Few of the in-scope NSPP-funded projects had a specific focus on pharmacotherapy, psychotherapy or psychosocial interventions for people with diagnosed mental illness. However, the ATAPS Suicide Prevention service initiative (Section 11.3) included these types of interventions.
Key findings
Several projects used indicated approaches aimed at improving access to care and support pathways for people following suicide attempts (for example, by improving transition from the emergency department to primary care or community mental health services).69 Beautrais et al, 'Effective Strategies for Suicide Prevention in New Zealand'.
70 Mann et al, 'Suicide Prevention Strategies'.
71 Nordentoft, 'Crucial Elements in Suicide Prevention Strategies'.
72 van der Feltz-Cornelis et al, 'Best Practice Elements of Multilevel Suicide Prevention Strategies'.