Table 1 Papers on brief interventions included in Milner et al., 2014 review

Beautrais et al., 2010 [20]

RCT

New Zealand

DSH

Postcards (n = 327)

12 mths

Non-significant reductions in overall DSH in IX compared to TAU

Significant reduction in the rate of representati ons per person

Nil - cites other external and methodological factors influencing results.

Result influenced by the overall treatment model, the level of support already available, characteristics of the treatment setting (page 58

Bertolote et al., 2010 [30]

RCT

Multiple

SA

Phone calls

(n = 1867)

18 mths

3 sites increased SA in IX, 2 sites decreased SA.

Social support BIC may have reduced the sense of isolation, enhanced connectedness, and established a sense of a therapeutic alliance (page 199)

Bennewith, Stocks et al., 2002 [21]

Cluster RCT (in general practices)

UK

DSH

Letter to general practitioner (n = 2141)

12 mths

Non-significant increases in DSH in IX compared to TAU

Suicide prevention literacy Participants more willing to turn to their general practitioner for help in subsequent crises (page 6).

Patients awareness of the interest shown by the general practitioner may have led them to seek help in future crises (page 7).

(Carter et al., 2005) [30]

RCT

Australia

DSP

Postcards (n = 722)

12 mths

Non-significant reductions in DSP in IX compared to TAU Significant reduction in repetitions of DSP

Social support “Patients requiring hospital treatment for deliberate self poisoning may believe that their situation is hopeless, that no one cares about them, or that they are viewed as incompetent and undeserving of care… It may be that, when combined with the postcard intervention, a service model that emphasises respect for the patient, high quality medical and psychiatric management, and follow-up arrange-ments on discharge is able to reduce the feelings of lack of social connectedness.” (page 4)

(Carter, Clover et al., 2007) [31]

RCT

Australia

DSP

Postcards (n = 722)

12 mths

Non-significant reductions in DSP in IX compared to TAU Significant reduction in repetitions of DSP

Alternate behaviours Participants learnt sustained alternative behaviours to self poisoning (p 552)

(Carter, Clover et al., 2013) [32]

RCT

Australia

DSP

Suicide

Postcards (n = 722)

60 mths

Non-significant reductions in DSP in IX compared to TAU

Suicide prevention literacy it is possible that increased use of mental health out-patient services, general practitioners or community-based counselling services might have occurred in the intervention group (page 378) Social support Provides gesture of caring to counteracted feelings of loneliness … The intervention should be both genuine in delivery and linked to current services… The Postcards from the EDge intervention had some of these features (page 378) The postcards intervention might not be effective at all if delivered within the context of an uncaring, uncoordinated general hospital service that did not provide comprehensive psychosocial assessment (page 378). Alternate behaviours Learning of alternate behaviours, (p 379)

Cedereke, Monti et al., 2002 [22]

RCT

Sweden

SA Suicide

Phone calls (n = 216)

12 mths

No difference in SA in IX compared to TAU

Nil - cites methodological factors influencing results.

Chen, Ho et al., 2013 [23]

RCT

Taiwan

SA

Crisis card (n = 761)

6 mths

Non- significant reductions in SA in IX compared to TAU

Nil - cites other external factors influencing results.

The effectiveness of the postcard intervention relies on the level of social support already available and the overall treatment setting. The differences in the healthcare models may have resulted in different effects (p 6)

Cotgrove, Zirinsky et al., 1995 [24]

RCT

UK

SA

Green card (n = 105)

12 mths

Non-significant reductions in SA in IX compared to TAU

Social support Providing patients with a place to escape too, provides a way to obtain help, provides a way to communicate distress, indicates that individuals are interested in their wellbeing (page 575)

Evans, Morgan et al., 1999 [25]

RCT

UK

DSH

Green card (n = 827)

6 mths

Non-significant increases in DSH in IX compared to TAU

Nil - cites methodological factors influencing results.

Evans, Evans et al., 2005 [33]

RCT

UK

DSH

Green card (n = 761)

12 mths

Non-significant increases in DSH in IX compared to TAU

Nil - cites contextual factors influencing results (including lack of skilled handling of those in crisis by junior doctors) (page 187)

Fleischmann, Bertolote et al., 2008 [13]

RCT

Multiple

Suicide

Phone calls (n = 1867)

18 mths

Significant reductions in suicide in IX compared to TAU

Alternate behaviours & suicide prevention literacy BIC increased the awareness of suicide attempters about the problems that led to the suicidal act and helped them to find ways of solving suicidal crises (page 707). Social support enhanced a feeling of connectedness. Also, systematic follow-up contacts gave the patient a feeling of being seen and heard by someone (page 707).

Hassanian- Moghaddam, Sarjami et al., 2011 [26]

RCT

Iran

SA self-injury (cutting)

Postcards (n = 2300)

12 mths

Significant reductions in SA in IX compared to TAU

Social support Expression of ongoing concern and the offer of contact if needed was successful in reducing subsequent suicidal ideation and suicide attempt in a population of hospital-treated self-poisoning individuals (page 315)

Hassanzadeh, Khajeddin et al., 2010 [35]

RCT

Iran

SA

Phone calls (n = 632)

6 mths

Non-significant increases in SA in IX compared to TAU. Process related outcomes in favour of the IX.

Suicide prevention literacy IX improved attitude towards seeking support from outpatient/inpatient services, relatives and friends (page 9).

Kapur, Gunnell et al., 2013 [27]

RCT

UK

SH

Letters + phone + info leaflet (n = 200)

12 mths

Significant increases in SH in IX compared to TAU.

Suicide prevention literacy, methodological factors influencing results. Presenting to hospital with repeat episodes could reflect a reduced threshold for help-seeking or improved engagement with services engendered by receipt of the intervention (page 74)

Morgan, Jones et al., 1993 [28]

RCT

UK

DSH

Green card (n = 212)

12 mths

Non-significant reductions in DSH in IX compared to TAU

Suicide prevention literacy & Social support Offer of lifelines, by opening up availability of services, in itself can be effective even though patients may not need to use it (page 112)

Motto and Bostrom 2001 [3]

RCT

USA

Suic ide

Letter (n = 843)

15 yr

Significant reductions in suicide in IX compared to TAU

Social support Being joined to something meaningful outside oneself as a stabilizing force in emotional life (page 831)

Robinson, Yuen et al., 2012 [4]

RCT

Australia

SA DSH

Postcards (n = 165)

18 mths

Non-significant reductions in DSH in IX compared to TAU Process related outcomes in favour of the IX.

Cites other external and methodological factors influencing results. Suicide prevention literacy The majority of participants found receiving the postcard to be acceptable and more than half reported using the individual sources of help messages (page 149)

Vaiva, Ducrocq et al., 2006 [29]

RCT,

France

SA

Suic ide

Phone calls (n = 605)

13 mths

Non-significant reductions in SA compared to TAU. Process related outcomes in favour of the IX.

Suicide prevention literacy Telephone contact also enables the detection of people at high risk of further suicide attempts and timely referral for emergency care (page 4

Vijayakumar, Umamaheswari et al., 2011 [36]

RCT

India

SA

Phone calls (n = 680)

18 /12 mths

Significant decreases in SA in IX compared to TAU

Social support, alternate behaviours & suicide prevention literacy Provided a social support network; by increasing awareness about the problems that led to the suicidal act and hence helping in formulating an alternate coping mechanism, by enhancing a feeling of 'connectedness' and a feeling of being 'cared for' (page 247)