Effectiveness of brief interventions and contacts after suicide attempt: a systematic review and meta-analysis

Background: Following a suicide attempt, only a third of people receive outpatient treatment, highlighting the need for low-threshold brief interventions and contacts (BICs). We aimed to examine the effectiveness of BICs. Methods: In this systematic review and meta-analysis, we searched MEDLINE, Embase, Cochrane CENTRAL, PsycInfo, Web of Science, and ProQuest, and gray literature from inception to June 18, 2025, for randomized controlled trials of BIC in adults following a suicide attempt. Studies were included if they investigated the effectiveness of BICs compared with control for adults (aged 18-65) after a suicide attempt, intended to reduce suicide re-attempts, suicidal ideation, self-harm, non-suicidal self-injury, or linkage to mental health (MH) services. The main outcomes included suicide re-attempts, self-harm, suicidal ideation, non-suicidal self-injury (NSSI), and linkage to MH services. We extracted raw frequency counts and means/SDs for use in random-effects meta-analyses of odds ratios and standardized mean differences, respectively. Quality of the evidence was assessed with RoB 2 and GRADE. This study is registered with PROSPERO, CRD42022271143. Findings: = 89.8%; n = 6 studies). There were too few studies for an investigation of NSSI. Most trials showed some concerns (22 studies, 61%), while fewer showed high risk of bias (7 studies, 19%). Risk of bias, heterogeneity, and imprecision contributed to the downgrading of certainty. Interpretation: Our findings have important implications for clinical practice and suicide prevention. Even when delivered in a single session, BICs can effectively reduce the recurrence of suicide attempts and may also decrease suicidal thoughts. Although conclusions for self-harm recurrence and linkage to MH services were limited, these interventions can be considered a practical and potentially essential element of suicide prevention strategies. Further high-quality trials are needed to confirm effects across additional outcomes and populations. Funding: The study was supported by funding from the Swiss National Science Foundation (501100001711-205913); the EMDO Foundation of the University of Zurich; the HOLCIM enterprise for the Promotion of Scientific Further Education.