This review was undertaken to support the development of a clinical practice guideline for assessing and managing patients who are at risk for suicide. This guideline provides health care providers in the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) with a framework by which to screen for, evaluate, treat, and manage the individual needs and preferences of patients who may be at risk for suicide. The Guideline authors systematically searched and evaluated the literature published up to April 2018, created algorithms, and formulated 22 clinical recommendations. Risk management and treatment recommendations address both pharmacologic and non-pharmacologic approaches for patients with suicidal ideation and behaviour.
An editorial notes that the systematic review is, for the most part, a compilation of previously published reviews and as such it is not surprising that its conclusions do not differ much from those reviews. The authors summarise the findings as follows –taken together, “evidence-based” studies seem to show, at most, modest benefit for both psychosocial and psychopharmacologic interventions largely involving persons enrolled in randomized controlled trials.”