Acute-Phase Interventions After Self-Harm for Preventing Suicide and Recurrence: A Systematic Review and...

Area of Science:

• Psychiatry
• Public Health
• Clinical Psychology

Background:

• Suicide risk is significantly higher after self-harm presentations.
• Evidence for early interventions in this high-risk period needs synthesis.
• Identifying effective early interventions is crucial for psychiatric care and prevention.

Purpose of the Study:

• To systematically review and meta-analyze randomized clinical trials (RCTs) of interventions initiated within one month of self-harm presentation.
• To assess the effectiveness of early interventions in reducing repeat self-harm and suicide mortality.
• To identify moderators of intervention effects.

Main Methods:

• Systematic review and meta-analysis of RCTs.
• Searched multiple databases (PubMed, Embase, PsycINFO, ICTRP, ClinicalTrials.gov) up to April 2025.
• Used Cochrane RoB 2 for risk of bias and GRADE for certainty of evidence.
• Conducted random-effects meta-analyses and meta-regressions.

Main Results:

• Included 60 RCTs with 22,654 participants.
• No intervention significantly reduced repeat self-harm.
• Problem-solving therapy showed reduced suicide mortality at medium-term follow-up (6-12 months).
• Brief intervention and contact showed reduced suicide mortality at long-term follow-up (>12 months).

Conclusions:

• Early interventions within one month of self-harm presentation had small, non-significant effects on repeat self-harm.
• Structured problem-solving and brief contact interventions are associated with reduced suicide mortality.
• Findings support scalable early interventions and highlight future research priorities for suicide mortality detection.