Caring Cards are a Simple, yet Effective Suicide Prevention Strategy

by Cathrine Frank, MD, MI Mind Program, Co-director

Multiple studies demonstrate that Caring Cards are an effective strategy to reduce risk of suicide. In a novel five year study, a group of 834 patients who had refused ongoing care but were at risk for suicide were divided into two groups: One group received a letter from their provider at least four times a year for five years. The other group received no further contact.

When compared with the group that did not receive letters, the letter-receiving group had a lower rate of suicide all five years of the study. Formal survival analyses revealed a significantly lower rate in the contact group (p=.04) for the first two years; differences in the rates gradually diminished over the following years. This simple and low cost strategy has been replicated in more than 11 well controlled studies. (Original study: Motto, J. A., & Bostrom, A. G. A randomized controlled trial of post-crisis suicide prevention. Psychiatric Services. 2001;52(6), 828- 833.)

Caring Cards can take the form of letters, emails, texts or phone calls, but letters ensure patient confidentiality.

The MI Mind team has created four online templates, available on the MI Mind website, to fit various patient scenarios:

  1. Inpatients and residential patients at the time of discharge
  2. Outpatients with acute risk, suicidal ideations or high PHQ-9 score
  3. Outpatients requesting refills who missed an appointment
  4. Outpatients who missed an appointment.

Follow up with a caring card for every patient who fits one of these scenarios. Simply add your own and your patient’s information to the appropriate letter where indicated in bold on the template. If you have questions about using the letters, email


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