World Psychiatric Association (WPA) President, Prof. Danuta Wasserman, Introduces the Brief Motivational Intervention and Long-term Regular Follow-up Contact Program (BIC)
As part of my 2023-2026 Action Plan, I wish to introduce you and welcome your collaboration on a crucial global health initiative led by the World Psychiatric Association (WPA) in collaboration with the Swedish National Centre for Suicide Research and Mental Ill Health Prevention (NASP) at Karolinska Institutet (KI) and a WHO collaborating centre.
I as the President of the WPA propose a clinical and scientific study in a collective pursuit of improving public health outcomes by preventing suicidal behaviours.
Suicide prevention is essential in any strategy aimed at improving overall health outcomes.
The drive for this initiative is grounded in historical precedents, where global crises have led to significant mental health repercussions. During such periods, societies witnessed heightened levels of stress, anxiety, and unfortunately, an increase in suicide down the line. Learning from the past, the challenges need to be pre-emptively addressed by implementing evidence-based methods that have shown promise in previous studies.
Providing timely treatment and continuous follow-up care for individuals with a history of suicide attempts is considered one of best practice in suicide prevention. The WHO Brief Motivational Intervention and Long-term Regular Follow-up Contact Program (BIC) is one such intervention for persons who have attempted suicide.
The effectiveness of the BIC program was demonstrated through a multicentre randomised controlled trial (RCT) conducted under the WHO SUPRE-MISS initiative. This trial spanned five countries—Brazil, India, the Islamic Republic of Iran, Sri Lanka, and China—and assessed individuals who presented at emergency departments following suicide attempts(1). Participants in the intervention group received brief intervention, explaining risk and protective factors for suicidal behaviours and possibilities for prevention, as well as the importance of compliance with prescribed treatment combined with follow-up care of up to 18 months by volunteers, independent of psychiatric treatment. The follow-up was structured to be intensive initially, occurring at 1,2,4,8, and 12 weeks, and then at 4,6, and 12 months, with support gradually lessening over time. Results showed a statistically significant reduction in suicide rates among participants who received the BIC program compared to the TAU-only group (0.2% vs. 2.2%, χ² = 13.83, P < 0.001).
In adapting this framework, the BIC project plans to expand its reach and invites you to use and evaluate your clinical work. You are allowed to use the methodology and conduct and publish studies while acknowledging the WPA.
Our objective is clear: to reach individuals at risk for suicide, intervene and provide continuous support through a structured program.
This study is not only about intervention, but also about understanding barriers to effective implementation and ensuring that our approaches are culturally adopted and feasible within different healthcare infrastructures. It’s about building a robust evidence base that can inform future national psychiatric policies and practices.
On our BIC page, you will find more information on the program as well as:
A training manual presentation of the BIC study by Dr. Natalie Riblet, Assistant Professor of Psychiatry at Dartmouth Geisel School of Medicine.
A Q&A session between Drs. Natalie Riblet and Nuhamin Petros, Project Coordinator at KI and the WPA, to equip centres with the tools needed to conduct this type of study and to foster a collaborative network across countries.
In conclusion, the BIC project is not merely a response to a temporary crisis but a proactive approach to a longstanding issue. It represents a commitment to mental health and well-being, a commitment to building stronger, more resilient societies.
As we move forward, we seek the support of global health communities, governments, and non-governmental organisations. Together, we can implement a project that not only saves lives but also enhances the quality of life for individuals across the globe.
Thank you for your attention and support as we embark on this vital journey towards a healthier, more hopeful world. I hope you find the training and discussions useful and informative.
Danuta Wasserman
WPA President
Author: Prof. Danuta Wasserman, President, WPA
References
Fleischmann A, Bertolote JM, Wasserman D, De Leo D, Bolhari J, Botega NJ, De Silva D, Phillips M, Vijayakumar L, Värnik A, Schlebusch L. Effectiveness of brief intervention and contact for suicide attempters: a randomised controlled trial in five countries. Bulletin of the World Health Organization. 2008 Sep;86(9):703-9.