Attempted Suicide Short Intervention Program for Older Adults (ASSIP-OA): An Evaluation of a Psychosocial Intervention for Suicidal Adults Aged 65+

NCT ID: NCT06831942

Last Updated: 2025-11-18

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 132 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-10-01
• Study Completion Date: 2031-06-30

Brief Summary

Older adults are sorely underrepresented in suicide prevention research, despite the fact that suicide rates are higher in this age group than in any other age group in Sweden and in many countries worldwide. There are extremely few clinical intervention studies that target this age group, with to date no published studies in Europe. The overall aim is to develop and test a modified version of the Attempted Suicide Short Intervention Program (ASSIP), which the investigators will adapt specifically for older adults (65+). The original ASSIP was developed in Switzerland where it has shown an 80% decrease in risk of new suicide attempts compared to ordinary treatment. In Sweden, ASSIP is currently being tested for persons aged 18+ . The investigators now propose a randomised controlled trial (RCT) to evaluate a modification of ASSIP specifically designed to meet the needs of suicidal persons aged 65 and above, the ASSIP-Older Adult program (ASSIP-OA).

Main study questions

1. Compared to treatment as usual (TAU), will the addition of the ASSIP-OA to ordinary treatment have a preventive effect on suicide and suicide attempts within 6, 12, and 24 months following the index episode?

2. Compared to TAU, do ASSIP-OA participants show better improvement in coping skills and psychiatric symptoms a) after the last session and b) at 6-,12- and 24- month follow-up?

3. Is a brief preventive intervention (ASSIP-OA) for older adults feasible, based on its acceptability, appropriateness, deliverability and fidelity? Do participants experience side effects? Do they have fewer days of inpatient care?

4. What kind of challenges and opportunities do a) older adults and b) ASSIP-OA therapists experience in relation to implementing a brief preventive intervention like ASSIP-OA? Are the modifications that the investigators made in ASSIP-OA relevant for older adults?

Conditions

Suicidal Ideation; Suicide Attempt; Suicide

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

ASSIP-OA

The ASSIP-OA intervention and treatment as usual (TAU)

Group Type: EXPERIMENTAL

ASSIP-OA

Intervention Type: BEHAVIORAL

ASSIP-OA + TAU

• First session. Narrative interview focusing on the background of the suicidal crisis. The patient receives a psychoeducational text to read and comment on as homework.
• Second session. Video playback. The patient and therapist watch the video recording from session 1 together, periodically pausing the video to comment and add information.
• Third session. Compilation of a written case conceptualization of the individual's vulnerability and triggering events that preceded the suicidal crisis.
• Fourth session. An optional extra session to further train safety strategies.
• Fifth session (optional). Includes one or two close relatives or other support person(s), chosen by the participant. The session focus on how safety measures learned in in ASSIP-OA can be translated into everyday life.
• Standardized letters. therapists will send standardized letters every third month during the first year and biannually during the second year.

Treatment as Usual

Ordinary treatment

Group Type: ACTIVE_COMPARATOR

Treatment as Usual (TAU)

Intervention Type: OTHER

Antidepressant medication, alone or in combination with other types of psychoactive drugs (sedatives/antipsychotics/hypnotics/mood stabilizers) constitute the cornerstone of treatment for suicidal older adults. Persons with serious depression or treatment-resistant depression may be offered electroconvulsive therapy (ECT). Some persons may receive supportive/therapeutic contacts with mental health professionals (nurses/social workers/psychologists) but no psychosocial interventions designed specifically for suicidal older adults are offered as part of ordinary treatment at the participating clinics.

Interventions

ASSIP-OA

ASSIP-OA + TAU

• First session. Narrative interview focusing on the background of the suicidal crisis. The patient receives a psychoeducational text to read and comment on as homework.
• Second session. Video playback. The patient and therapist watch the video recording from session 1 together, periodically pausing the video to comment and add information.
• Third session. Compilation of a written case conceptualization of the individual's vulnerability and triggering events that preceded the suicidal crisis.
• Fourth session. An optional extra session to further train safety strategies.
• Fifth session (optional). Includes one or two close relatives or other support person(s), chosen by the participant. The session focus on how safety measures learned in in ASSIP-OA can be translated into everyday life.
• Standardized letters. therapists will send standardized letters every third month during the first year and biannually during the second year.

Intervention Type: BEHAVIORAL

Treatment as Usual (TAU)

Antidepressant medication, alone or in combination with other types of psychoactive drugs (sedatives/antipsychotics/hypnotics/mood stabilizers) constitute the cornerstone of treatment for suicidal older adults. Persons with serious depression or treatment-resistant depression may be offered electroconvulsive therapy (ECT). Some persons may receive supportive/therapeutic contacts with mental health professionals (nurses/social workers/psychologists) but no psychosocial interventions designed specifically for suicidal older adults are offered as part of ordinary treatment at the participating clinics.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Age 65 and above at time of index suicide attempt or hospitalisation for serious suicidal plans.

2. A mental health care contact during the active treatment period.

3. Capable of understanding study procedures and providing informed consent.

Exclusion Criteria

1. Clinical diagnosis of dementia or MoCa score less than -2 standard deviations from the normative score for education and age (Borland et al., 2017). Ongoing delirium, or any other condition impeding the comprehension of the study's procedures and implications that hinder the provision of informed consent.

2. Severe ongoing psychosis, severe ongoing substance use disorder, emotionally instable personality syndrome and any other condition that would require longer specialized treatment to reduce future suicidal behaviour (e.g. DBT).

3. Terminal illness.

4. Insufficient knowledge of the Swedish language (requires interpreter).

5. Aphasia or other severe communication issue or severe hearing and/or severe visual impairment that render the intervention unfeasible despite corrective aids.

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Göteborg University

OTHER

Sponsor Role: collaborator

Vastra Gotaland Region

OTHER_GOV

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Margda Waern, Professor

Role: PRINCIPAL_INVESTIGATOR

Department of Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden

Locations

Södra Älvsborg Hospital

Borås, , Sweden

Site Status: RECRUITING

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status: NOT_YET_RECRUITING

Countries

Sweden

Central Contacts

Sara Hed, Phd Student

Role: CONTACT

sara.hed@gu.se

+46735324985

Margda Waern, Professor

Role: CONTACT

margda.waern@neuro.gu.se

Facility Contacts

Carina Forsberg

Role: primary

carina.forsberg@vgregion.se

+4676-940 29 47

Sara Hed

Role: primary

sara.hed@gu.se

+46735324985

Other Identifiers

2023-00181

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2024-07392-01

Identifier Type: -

Identifier Source: org_study_id