Implementation of a suicide risk prevention program in the Autonomous Community of Madrid. The ARSUIC experience

Introduction. This study evaluates the degree of compliance and effectiveness of the ARSUIC Suicide Risk Care Program. ARSUIC seeks to reduce the relapse risk that follows a suicide attempt by scheduling a high priority outpatient visit following hospital discharge. Method. Hospital-based retrospective study conducted between years 2012 and 2015. We included every suicide attempt treated at the La Paz University Hospital's mental healthcare resources network. We estimated the time between hospital discharge and the first outpatient visit; the proportion of visits that fulfill the program's objective - a follow-up within a maximum of 7 days; the suicide attempt rate; and the percentage of attempts corresponding to relapses, by study year. Results. After program deployment, median time between discharge and the first visit decreased from 8.5 to 6 days, and the percentage of visits that fulfill the program's objective increased from 32 to 48.5%. Between years 2012 and 2015, the suicide attempt rate per person and year decreased from 1.20 to 1.08 and the proportion of attempts corresponding to relapses from 26.6% to 12.8%. Conclusion. Implementing the ARSUIC Program lowered the time between discharge and the first outpatient visit following a suicide attempt. The proportion of suicide attempts due to relapses and the suicide attempt rate per person decreased progressively. The program fulfilment proportion was under 50%, suggesting between-user differences regarding their effective access to the program.