Impact of Tailored Interventions on Suicidal Ideation Recovery: Addressing Hopelessness Among Economically Vulnerable Populations During COVID-19 Period

초록

Background Public health crises—most recently exemplified by the coronavirus disease 2019 (COVID-19) pandemic—cause widespread psychological, social, and economic disruptions, contributing to increased depression, anxiety, and suicidal ideation rates. This study aims to examine the clinical characteristics and treatment outcomes of individuals who attempted suicide during the COVID-19 pandemic, focusing on the effectiveness of tailored interventions for economically vulnerable individuals. Methods This study was conducted as part of the “Post-management Service for Suicide Attempters in the Emergency Room” project. Overall, 93 individuals who had attempted suicide were recruited, with 49 completing the study. Participants were categorized based on economic status (vulnerable vs. general) and suicide attempt timing (during vs. after COVID-19). The intervention included structured counseling sessions (six and four sessions for the vulnerable and general group, respectively). The vulnerable group received two additional sessions tailored to individual needs, choosing from family counseling, mental health education, social skills training, or vocational rehabilitation. Clinical assessments—Beck Scale for Suicidal ideation (BSS), Beck Hopelessness Scale (BHS), Beck Depression Inventory-II, and Beck Anxiety Inventory—were conducted at baseline and follow-up, with statistical analyses using linear regression, mixed-effects analysis of variance, and Pearson correlation. Results Changes in BSS scores negatively correlated with baseline BHS scores (B = −0.841, β = −0.593, P = 0.009) and intervention type (B = −4.596, β = −0.296, P = 0.040). During the COVID−19 intervention period, BSS scores improved greatly in the vulnerable group than in the general population group (F = 4.324, P = 0.049). Post−COVID−19, no significant group differences were observed in outcome measures. Changes in BSS scores positively correlated with changes in BHS scores across the total study population (r = 0.567, P < 0.001), general population group (r = 0.485, P = 0.016), and vulnerable population group (r = 0.641, P = 0.001). Conclusion Tailored interventions were associated with reduced suicidal ideation, particularly among economically vulnerable individuals during the COVID-19 pandemic. Addressing hopelessness emerged as a key mechanism in suicide prevention. The observed enhancement during the pandemic highlights the importance of context-sensitive strategies in public health crises. Further research using larger, randomized controlled trials is warranted. Trial Registration Clinical Research Information Service Identifier: KCT0009463

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