Subsequent suicide acts of 1830 suicidal crisis hotline callers: A one-month follow-up study

Suicide is a concerning public health issue. This study aimed to explore the person-time incidence rate of suicide acts and to identify the risk factors of suicidal acts during the one-month follow-up period among suicidal hotline callers.

A prospective longitudinal study was conducted in Guangzhou Psychological Aid Hotline between Feb 2020 and June 2021. Information about subsequent suicide acts was collected during four telephone follow-ups in one month after the index call. The person-time incidence rate of subsequent suicide acts was calculated. Multivariate logistic regression and Anderson-Gill regression were used to evaluate the risk factors of subsequent suicidal acts.

A total of 1830 suicidal callers were included. During the follow-ups, 200 callers had made at least one suicide attempt (35 callers attempted more than once) and 5 callers died by suicide. Approximately 60 % of suicide attempts happened during the first week after the index call. The person-time incidence rate was 16.0/100 person-month. Younger age (OR = 0.94, HR = 0.91), history of mental disorders (OR = 1.93, HR = 1.88), history of suicide attempt (OR = 1.58, HR = 1.99), suicide plan or suicide attempt at baseline (vs. suicide ideation, OR = 1.83, HR = 2.44; OR = 1.95, HR = 2.31, respectively) were predictors of subsequent suicide act (P < 0.05).

Hotline callers were a high-risk population for suicide even after intervention. The highest suicide risk of the callers was in the first week after the call, followed by a gradual decline. More robust and intense interventions should be taken to reduce suicide risks in suicidal callers.