Suicide Prevention Among Recipients of Care

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1520 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-05-20

Study Completion Date

2024-07-07

Brief Summary

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Randomized controlled trial to determine the best brief suicide prevention intervention for adults and adolescents who screen positive for suicidal ideation or behavior in emergency departments or primary care clinics.

Aim 1: Compare the effectiveness of two brief suicide prevention interventions (safety planning intervention plus structured phone-based follow-up from a suicide prevention hotline (SPI+), versus safety planning intervention plus caring contacts (CC)) to (a) reduce suicidal ideation and behavior, (b) reduce loneliness, (c) reduce return to care for suicidality, and (d) increase uptake of outpatient mental healthcare services over 12 months among adult and adolescent patients screening positive for suicide in emergency departments (EDs) and primary care clinics.

Aim 2: Assess the acceptability of connection and support planning and the safety planning intervention, with or without follow-up among providers and clinical staff in EDs and primary care clinics.

Aim 3: Assess the acceptability of SPI+ and SP+CC among adult and adolescent patients.

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Detailed Description

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Conditions

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Suicide Suicide, Attempted Suicidal Ideation Social Support Secondary Prevention Patient Care Planning Outpatients Outpatient Clinics, Hospital Mental Health Services Mental Health Mental Disorder Loneliness Emergency Service, Hospital Depressive Disorder Depression Continuity of Patient Care Ambulatory Care Adolescent Adult Crisis Intervention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Individual-level randomization to one of two treatment arms

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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SPI+: Safety Planning Intervention plus structured phone-based follow-up

The Safety Planning Intervention (SPI+) includes safety planning (moderate or high risk for suicide) or connection \& support planning (low risk for suicide) at the clinic or ED, plus a structured telephone-based intervention from a suicide prevention hotline

Group Type EXPERIMENTAL

SPI+

Intervention Type BEHAVIORAL

Suicide prevention hotline follow-up specialists will call participants to (1) conduct a brief suicide risk assessment; (2) review and discuss the participant's connection and support plan or safety plan; and (3) provide referrals to social services or other support with treatment engagement, if indicated. Participants will receive at least one and optional additional phone calls, generally delivered according to the following schedule: days 3, 7, 14, 30, 60, 90. Modifications may be made to the schedule due to weekends, holidays, or participant availability, and additional calls may be scheduled as desired by the participant. The follow-up will stop once the participant is successfully engaged in outpatient treatment or does not desire further follow-up support.

Caring Contacts: Safety Planning Intervention plus Caring Contacts (SP+CC)

SP+CC will include safety planning (moderate or high risk for suicide) or connection \& support planning (low risk for suicide) at the clinic or ED, plus caring text messages or emails from a suicide prevention hotline.

Group Type EXPERIMENTAL

SP+CC (Caring Contacts)

Intervention Type BEHAVIORAL

SP+CC follow-up includes one phone conversation with a suicide prevention hotline follow-up specialist and a series of personalized caring messages sent over the course of 12 months via text or email (based on participant preference). Caring contacts will generally be sent according to the following schedule: 3 in the first week, 6 weekly, 6 bi-weekly, 4 monthly; 2 bi-monthly, and one each for the participant's birthday, Thanksgiving, Christmas, and New Year's (total of 25 over 12 months). Slight variation in the schedule is allowed. There is no expectation that participants respond to the text messages; if they do, follow-up specialists reply to any incoming texts. Replies are individually-tailored and caring.

Interventions

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SPI+

Suicide prevention hotline follow-up specialists will call participants to (1) conduct a brief suicide risk assessment; (2) review and discuss the participant's connection and support plan or safety plan; and (3) provide referrals to social services or other support with treatment engagement, if indicated. Participants will receive at least one and optional additional phone calls, generally delivered according to the following schedule: days 3, 7, 14, 30, 60, 90. Modifications may be made to the schedule due to weekends, holidays, or participant availability, and additional calls may be scheduled as desired by the participant. The follow-up will stop once the participant is successfully engaged in outpatient treatment or does not desire further follow-up support.

Intervention Type BEHAVIORAL

SP+CC (Caring Contacts)

SP+CC follow-up includes one phone conversation with a suicide prevention hotline follow-up specialist and a series of personalized caring messages sent over the course of 12 months via text or email (based on participant preference). Caring contacts will generally be sent according to the following schedule: 3 in the first week, 6 weekly, 6 bi-weekly, 4 monthly; 2 bi-monthly, and one each for the participant's birthday, Thanksgiving, Christmas, and New Year's (total of 25 over 12 months). Slight variation in the schedule is allowed. There is no expectation that participants respond to the text messages; if they do, follow-up specialists reply to any incoming texts. Replies are individually-tailored and caring.

Intervention Type BEHAVIORAL

Other Intervention Names

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phone-based follow-up, brief contact intervention Brief contact intervention, text-based follow-up, email follow-up

Eligibility Criteria

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Inclusion Criteria

* Patient at St. Luke's Health System Emergency Department or Primary Care Clinic
* 12-17 years old (adolescents) or 18+ years old (adults)
* Screened positive for suicide risk on C-SSRS (any response of "yes") during current visit, or current visit is related to a suicide attempt
* Access to a phone for the duration of the study with the ability to receive calls
* The ability to send and receive email messages (required) and text messages (optional)
* English or Spanish speaking and reading