Wish you were here. Postcards reduced suicide in non-Western self-poisoners

postcard

Researchers from Shahid Beheshti University in Iran have been studying the efficacy of a novel intervention for reducing suicidal behaviour.  For a year, they have been sending postcards to people who self poison in the hope that it will reduce their suicidal ideation and attempts.

Their randomised controlled trial published in the British Journal of Psychiatry studied 2,300 individuals, who were either sent 9 postcards or given the usual treatment over a 12 month period. The outcomes assessed at 12 months (n=2,113) were suicidal ideation, suicide attempts and self-cutting (proportion and event rates).

They found a significant reduction in:

  • any suicidal ideation (relative risk reduction (RRR) = 0.31, 95% CI 0.22-0.38)
  • any suicide attempt (RRR = 0.42, 95% CI 0.11-0.63)
  • and number of attempts (incidence rate ratios (IRR) = 0.64, 95% CI 0.42-0.97).

There was no significant reduction in:

  • any self-cutting (RRR = 0.14, 95% CI -0.29 to 0.42)
  • or self-cutting events (IRR = 1.03 95% CI 0.76-1.39).

Unfortunately the study abstract doesn’t go into much detail and explain what was actually on the postcards.

The research team concluded that:

A postcard intervention reduced suicidal ideation and suicide attempts in a non-Western population. Sustained, brief contact by mail may reduce suicidal ideation and suicide attempts in individuals who self-poison.

Hassanian-Moghaddam H, Sarjami S, Kolahi AA, Carter GL. Postcards in Persia: randomised controlled trial to reduce suicidal behaviours 12 months after hospital-treated self-poisoning. Br J Psychiatry. 2011 Feb 22. [PubMed abstract]

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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