Implementations of an evidence-based assertive case management intervention for suicide attempters: Post-ACTION-J...

Area of Science:

• Public Health
• Psychiatry
• Health Services Research

Background:

• The ACTION-J randomized trial demonstrated the effectiveness of assertive case management in preventing suicide reattempts within 6 months.
• This intervention has been covered by Japan's national medical payment system since 2016, facilitating its broader adoption.
• Understanding the real-world implementation of such programs is crucial for optimizing mental healthcare delivery.

Purpose of the Study:

• To evaluate the current implementation status of the ACTION-J assertive case management intervention in a real-world clinical setting.
• To assess the feasibility and uptake of assertive case management among suicide attempters following its integration into a national healthcare system.

Main Methods:

• A prospective, multicenter registry cohort study (Post-ACTION-J Study - PACS) was conducted.
• Participants included suicide attempters admitted to 10 medical facilities between October 2016 and September 2018.
• The primary outcome measured was the duration and frequency of assertive case management intervention use over 6 months.

Main Results:

• Out of 1159 admitted patients, 144 were included in the analysis.
• 72.2% (104/144) of participants received the intervention for the full 6 months.
• 63.9% (92/144) completed at least 7 case management interviews within the 6-month period.

Conclusions:

• The findings confirm the successful implementation of the ACTION-J assertive case management program in a real-world clinical environment.
• Integration with Japan's national medical payment scheme supported the program's uptake.
• This study offers valuable insights for improving the future implementation of assertive case management interventions for suicide prevention.