Suicide attempters admitted to emergency medical departments because of serious injury often choose highly lethal suicide methods, such as hanging or jumping from high places. Prevention of suicide reattempts is important because a history of suicidal behavior, including suicide attempts, is the strongest risk factor for suicide. Additionally, suicide attempters tend to use more lethal methods in repeat suicide attempts.
 Sapporo Medical University Hospital, to which the authors belong, has the only advanced critical care and emergency center in Hokkaido, Japan. Data were analyzed for all admissions from 2016 to 2020. Only seriously injured suicide attempters are admitted to the center, and more than half of these subsequently die. More male than female suicide attempters die in the center. Hanging is the most common method of completed suicide, followed by jumping from high places. Almost all cases met the diagnostic criteria for mental illness; 42% received an F3 (mood disorder) classification according to the International Classification of Diseases and Related Health Problems 10th revision.
 Suicide attempters received an assertive case management intervention. The intervention's effectiveness in preventing suicide reattempts had been previously demonstrated by a randomized controlled multicenter trial (ACTION-J study) conducted at Sapporo Medical University Hospital. The intervention program was adopted by the medical payment scheme in 2016, and 58 suicide attempters received the intervention program in Sapporo Medical University Hospital before April 2021. Following the intervention, there were no suicide reattempts for 6 months. The intervention program seems implementable at the facility, where suicide attempters admit to an emergency medical department after serious injury.
 Authors' abstract