In industrialised countries, the incidence of suicide attempts (SAs) among adolescents 10–19 years old [
1] is estimated to be at 7 to 9 % [
2,
3]. Almost one third of these adolescents will make another SA within 1 year. A previous SA may be “an independent and powerful predictor of future attempts”. This “crescendo model of suicidality” concept was developed by Wong [
4]: once an SA occurs, the risk of another attempt is increased. Moreover, one of the risk factors of SAs is a first attempt, in particular during the year preceding the attempt. To prevent suicide, we must prevent SAs and particularly their recurrence.
In general, research of adolescent suicide attempters has focused on risk or protective factors [
5‐
7]. However, despite knowledge of these characteristics, the rate of SA recurrence has not decreased. So, care proposals must be creative to limit the recurrence. These last decades, new ways to prevent SA recurrence are being developed for adult suicide attempters. These new ways may be divided into 2 categories: intensive and connectedness care [
8]. Intensive care includes specific therapies such as cognitive-behaviour or dialectical behavior therapy [
9‐
12], partial hospitalization [
13], and brief psychological interventions at patients’ homes [
14]. With some of these treatments, the rate or recurrence has decreased: SA recurrences were reduced 50 % with than without dialectical behavior therapy [
11] and the same trend was found in the Weinberg or Fonagy study [
12,
13]. Connectedness care involves keeping in touch with patients and encouraging them to call in case of crises in order to avoid the SA recurrence. Motto et al. were pioneers in the field of connectedness care at the end of the 1970s by sending letters to suicide attempters at a regular frequency after the SA [
15]. The care may also involve sending postcards [
16,
17], making phone calls [
18,
19] or using short message service (SMS) [
20]. As for intensive care, this care may have positive results on the rate of recurrence or the number of recurrences. In the study of Evans, risk of SA recurrence was reduced for patients who received versus did not receive postcards (odds ratio 0.64). In the Vaiva study, for patients with this care, SA recurrence was reduced 10 % as compared with others in the first 6 months after the SA. These different care modalities have diverse results depending on the sex or personality of the patient [
21].
Both types of care have clinical relevance, but the connectedness care is easy to use, has low cost and seems appropriate for adolescents. Indeed, the therapeutic alliance with young patients is not easy to achieve, and intensive care might prevent them from relating to the care. Moreover, in another study in Nancy, France, being lost to follow-up by caregivers was a risk factor of SA recurrence, even 10 years after the SA [
22]. Thus, keeping in touch with adolescents after an SA is important, and adolescents may easily accept the idea if presented in a medium they often use: SMS. Some MobilHealth programs have shown good results with the system for adolescents as for adults in other specialties [
23,
24].
The MEDIACONNEX study proposes to assess the effectiveness of a new way of connectedness care for adolescents after an SA: it is based on SMS sent over 6 months after the SA to allow adolescents to access care more easily and so limit the risk of SA recurrence.