Understanding Compliance Rates in Suicide Research During the Post-Discharge Period

The period following discharge from psychiatric hospitalization is one of particularly elevated suicide risk. It is essential to better understand risk factors for suicide during this period; however, retention and compliance in longitudinal research can be a challenge with high-risk populations.

We examined compliance rates in the six-month period following psychiatric hospital discharge among 174 adults (149 psychiatric patients and 25 healthy controls) across three data collection methods: ecological momentary assessment (EMA), weekly clinical assessment phone calls, and clinical follow-up assessments at two- and six-months post-discharge. We examined whether clinical and demographic characteristics influenced compliance rates.

Results suggested low rates of EMA compliance, but strong rates of completion of weekly phone calls and follow-up assessments. Compared to psychiatric patients, healthy controls completed more EMA and weekly phone calls, but not follow-up assessments. Participants who met current diagnostic criteria for a major depressive episode and who scored above the clinical threshold for borderline personality disorder symptoms had lower EMA compliance rates.

These findings have important implications for strategies to improve patient engagement in research during this high-risk period.