"Many people who attempt suicide end up in an emergency room for immediate treatment. But few of those suicide survivors get the followup care they need at a time when they are especially likely to attempt suicide again httpsajp.psychiatryonline.orgdoiabs.appi.ajp..journalCodeajp. Now a study shows that a simple intervention conducted by staff in emergency departments can reduce the risk of future attempts. The intervention involves creating a safety plan for each patient and following up with phone calls after discharge. It reduced the odds of suicidal behavior by half says Barbara Stanley https a psychologist at Columbia University and the lead author of the study. Thats a phenomenal difference. The study which was published Wednesday httpsjamanetwork.comjournalsjamapsychiatryfullarticle in JAMA Psychiatry included  patients at five Veterans Affairs hospitals around the country. The findings offer a way for hospitals and clinics to help reduce the rising numbers of death https by suicide across the country. You Are Not Alone If you or someone you know may be considering suicide contact the National Suicide Prevention Lifeline at  en Espaol  deaf and hard of hearing  or the Crisis Text Line by texting . When someone goes to the emergency room for a suicide attempt they are at risk of another suicide attempt for the next three months says Stanley. Its like a ticking time bomb. This is the first largescale study of the Safety Planning Intervention http_Safety_Planning.html which Stanley and her group developed in  and which has been adopted at hospitals and clinics around the country. It can be provided by a physician a nurse or a social worker and requires very little training. The interesting thing about the Safety Planning Intervention is that it is a relatively brief intervention and can be used in a lot of different health care settings says Brian Ahmedani https director of behavioral health research at the Henry Ford Health System in Detroit who wasnt involved in the new study. Article continues after this message from our sponsor Many health care systems are starting to think about ways to prevent suicide he says. Thats because as his own work has shown almost  percent https of people who die by suicide make a health care visit in the year before their death. Yet only  percent of those people have been diagnosed with a mental illness. The intervention studied by Stanley and her group starts in the ER or a clinic before the suicidal patient is released. First a health care professional talks with the patient and tries to understand that persons warning signs for a suicide attempt. If theyve grappled with being suicidal they know what their warning signs are says Stanley. For example she says someone might say  I find that Im staying in my room not answering the phone not answering texts not answering emails. That could be a warning sign. Others might have repeated thoughts that theyre not worthy. The next step is for the patient  with help from the clinician  to come up with a set of coping strategies to help get through moments of intense suicidal ideation. For most people this intense state only lasts from a few minutes to a couple of hours she says. The coping strategy could be something as simple as playing video games watching TV or talking to a loved one. If people contemplating suicide can distract themselves with something they enjoy doing they can bypass that narrow window during which suicidal thoughts can overpower them notes Stanley. For suicidal people the passage of time is their friend she says. The provider also tries to persuade patients to remove or distance themselves from their means of suicide. For example if they own a gun they should lock it away or give it to someone who can keep it away from them. If you make it really hard to use whatever means you were going to use time passes and you give a chance for suicidal thoughts to subside she says. Safety planning includes followup phone calls with the patient  the first call is made within  hours of being discharged from the ER. The provider asks the patient how the safety plan is being used and helps revise it if needed. The provider also makes sure the patient sees a mental health care provider for longterm care. A provider keeps calling until the patient has had a second appointment with a therapist or counselor. That followup is key says Julie Goldstein Grumet a psychologist at the Zero Suicide Institute at the Education Development Center a Washington D.C.based nonprofit. People often fall off and they dont follow up on their referrals she says. And the times during these transitions from acute care settings is one of the highest risk times of suicides. To evaluate the effectiveness of the intervention Stanleys team looked at five VA emergency departments across the country that used it and compared the outcomes with four VA emergency rooms that simply discharge patients after stabilizing them. Among the nearly  people who received the intervention half as many people had made suicide attempts or had come very close as those in the control group. In other words the intervention had nearly halved the risk of suicide in the six months after discharge. Twothirds of the people in the treatment group had used their safety plans and they were also twice as likely to get followup mental health treatment when compared with the control group. The study is incredibly important ... because it shows brief interventions work says Goldstein Grumet. Rick a father in Missouri says a safety plan may have saved his yearold daughters life. NPR is leaving off his last name to protect his daughters privacy. In September  she came very close to taking her own life. When he found out about this from her school principal the next day Rick rushed her to the ER at Mercy Hospital Jefferson https The whole process was overwhelming because you have your yearold whos wanting to end her life Rick says. And shed not shared any of that with us.  The hospital wasnt part of the new study but was also using a safety planning intervention as part of its efforts to prevent suicides. The crisis counselor did such an amazing job of setting up a safety plan that my daughter felt comfortable with he says. He says his daughter didnt want to talk to him or her mother about her struggles but she agreed to communicate with them in other ways. During times when she felt her urge to take her own life coming back she agreed to watch TV with her mother or call or text her father. Rick says she usually sends a specific emoji when she is having a bad day. And he responds by distracting her with something completely different. He says she also agreed to use a crisis help line if things escalated. It was something that she could follow through with he says. It gave her some confidence and it gave me some confidence. He says the plan has helped his daughter get through her suicidal phase and even slowly open up to her parents. Thats what is so powerful about a safety plan says Ahmedani. The patient is the author of their safety plan but its guided by a provider. As part of the  National Strategy For Suicide Prevention http_reportrev.pdf many health care providers have adopted the approaches to prevention outlined in the Zero Suicide Initiative httpszerosuicide.sprc.org which includes safety planning based on previous evidence showing it works. While safety planning has begun to be used across the country it ought to be adopted universally says Goldstein Grumet. It is a brief intervention that hospital workers primary care staff outpatient behavioral health can all be trained in to utilize she says."