Hospital Outreach Postsuicide Attempt Engagement (HOPE)

Background: Individuals who have attempted suicide are at high risk of recurrence, necessitating targeted interventions. The Hospital Outreach Postsuicide attempt Engagement (HOPE) program provides psychosocial support postsuicide attempt, aiming to reduce re-presentations including those to the emergency department (ED). This study evaluated the longitudinal outcomes of HOPE participants compared to a matched treatment as usual (TAU) control group within a major health service in Victoria, Australia. Methods: This case-controlled study included 100 HOPE participants and 100 matched TAU participants. ED presentations were analyzed over 4 years (2 years pre- and post-HOPE) to assess frequency, type, and time to re-presentation. Results: There were no significant differences in the overall number of ED presentations between the HOPE and TAU groups. However, HOPE participants exhibited significantly fewer mental health-related ED presentations postintervention. Time to first mental health-related re-presentation did not differ significantly between groups. Limitations: Only participants who completed a minimum level of HOPE program engagement were included, precluding an intention-to-treat analysis. Conclusions: While the HOPE program reduced mental health-related ED presentations, it did not significantly extend the time to re-presentation for suicide attempts. These findings suggest that while beneficial for immediate care needs, HOPE may require integration with long-term community-based support to improve outcomes. Future research should explore broader measures of effectiveness, including patient-reported outcomes and quality of life metrics.