Impact of a High-resolution Program for the Prevention of Suicidal Behavior in At-risk Adults: a Quasi-experimental Ambispective Cohort Study

NCT07655986 | Recruiting DMC

• 1 other identifier: PI 2025 11 2102 - TD
• Study Type: interventional
• Target: 198
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Suicidal behavior represents a major public health problem worldwide. According to the World Health Organization (WHO), approximately 720.000 people die by suicide annually, and many more attempt it. Suicide is a personal tragedy associated with extreme suffering that has a serious impact on the deceased's immediate circle and on society as a whole. In this context, there is an urgent need to design effective and humane intervention strategies that offer an evidence-based, preventive, specialized, and community-oriented response to suicidal behavior. Objective: To evaluate the impact of a multidisciplinary, specialized, and high-resolution program for the prevention of suicidal behavior in adults aged 18 and over in the Salamanca Health Area. Methods: A quasi-experimental, ambispective cohort study with two parallel groups: an intervention group, receiving the specific suicide prevention program (SPP) with a pre-test/post-test design, and a control group, receiving usual care (TC). Adult patients (≥ 18 years) will be referred from the Emergency Department of the University Hospital of Salamanca after an initial psychiatric evaluation. Patients will be assigned to the intervention group according to established inclusion criteria. The program lasts 3 months, during which each participant will receive intensive and individualized follow-up from a multidisciplinary team composed of two psychiatrists, two mental health nurses, two psychologists, and two social workers at two community mental health centers. Participants will also attend 10 weekly group therapy sessions. Follow-up evaluations will be conducted at the end of the program (three months) and six months after the first contact. Discussion: This study will contribute to the scientific evidence base on the effectiveness of intensive and specific suicide prevention programs in the community setting, optimizing healthcare resources, improving treatment adherence, and aligning with the Spanish National Suicide Prevention Plan 2025-2027. Ethics and dissemination: This study has been approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm code: PI 2025 11 2102 - TD) Keywords: Suicidal behavior; Suicide prevention; Suicidal ideation; Community mental health services; Quasi-experimental study; Cohort study; Psychiatric emergency services; Patient care team.

Conditions

Prevention of Suicidal Behavior

Keywords

Suicidal behavior; Suicide prevention; Suicidal ideation; Community mental health services; Quasi-experimental study; Cohort study; Psychiatric emergency services; Patient care team

Outcome Measures

Primary Outcomes (1)

• Recurrence of Clinically Significant Suicidal Behavior

  Proportion of participants experiencing at least one clinically significant suicidal event during follow-up, defined as: (1) a new suicide attempt documented in the emergency department or clinical records; (2) urgent psychiatric hospitalization in a Short-Stay Inpatient Unit (UHB) due to suicidal behavior; or (3) completed suicide. Assessment Tool: Prospective registry via electronic clinical records (SACYL). For suicide attempts: emergency department records. For hospitalizations: inpatient admission records. For completed suicide: civil registry and/or clinical team notification. Scale: Dichotomous outcome (presence/absence of recurrence) and discrete quantitative variable (number of events: 0, 1, 2, 3...).

  3 months (end of program) and 12 months from first contact.

Secondary Outcomes (16)

• Type of Suicidal Behavior

  Baseline.

• Suicidal Ideation Severity.

  Baseline, 3 months, 12 months.

• Emergency Department Visits due to Suicidal Ideation

  3 months, 12 months.

• Global Clinical Impression of Suicidal Risk - Severity (CGI-SS-S)

  Baseline, 3 months, 12 months.

• Global Clinical Impression of Suicidal Risk - Improvement (CGI-SS-I)

  3 months, 12 months.

Study Arms (2)

Intervention group (PPS)

EXPERIMENTAL

Intervention group with application of the high-resolution program for the prevention of suicidal behavior in adults at risk.

Behavioral: PPS; SUICIDE PREVENTION PROGRAM

Control group (TH)

NO INTERVENTION

Control group with application of usual treatment in patients with suicidal behaviors

Interventions

PPS; SUICIDE PREVENTION PROGRAM BEHAVIORAL

The Suicide Prevention Program (PPS) is a high-resolution, outpatient program delivered by a multidisciplinary team consisting of two mental health nurses, two psychiatrists, two psychologists, and two social workers. It operates in two community mental health centers in Salamanca, belonging to the Specialized Care Management, over a three-month period. The first contact with the patient will be made by telephone within 24 hours of referral by a mental health nurse. The first in-person appointment will take place in a nursing consultation within 72 hours. The patient will have a maximum of 72 psychiatric appointments, a maximum of seven days for the first appointment with a psychologist, and a maximum of 14 days for the first appointment with a social worker. The program also includes 10 group sessions, in-person and telephone follow-up, and crisis intervention.

Intervention group (PPS)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients ≥ 18 years of age.
• No prior active follow-up by the mental health team.
• Prior stabilization by the emergency psychiatry team.
• Columbia Severity Rating Scale (C-SSRS) score corresponding to moderate-to-high risk.
• Absence of criteria for urgent hospital admission.
• Signed informed consent.
• Exclusión Criteria:
• Self-harm without suicidal intent.
• Mild suicide risk (mild C-SSRS).
• Extremely high suicide risk requiring urgent hospital admission.
• Patient under active follow-up at another mental health unit.

Sponsors & Collaborators

• University of Salamanca: lead
• Sanidad de Castilla y León: collaborator

Study Sites (1)

Hospital Universitario de Salamanca

Salamanca, Salamanca, 37185, Spain

RECRUITING

Related Publications (14)

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MeSH Terms

Conditions

Suicide Prevention; Suicidal Ideation

Interventions

Pentosan Sulfuric Polyester

Condition Hierarchy (Ancestors)

Suicide; Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Sulfuric Acids; Sulfur Acids; Sulfur Compounds; Organic Chemicals; Polysaccharides; Carbohydrates

Central Study Contacts

Lourdes Ollero Malagón, Mental health nurse specialist

CONTACT

+34682539709; lollero@saludcastillayleon.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor doctor, University of Salamanca

Study Record Dates

• First Submitted: May 15, 2026
• First Posted: June 18, 2026
• Study Start: May 1, 2025
• Primary Completion: May 1, 2026
• Study Completion (Estimated): May 1, 2027
• Last Updated: June 18, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)