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

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.