Suicide Prevention Among Recipients of Care

Summary

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.

Conditions

• 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

Interventions

BEHAVIORAL

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.

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.

Sponsors & Collaborators

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• Idaho Crisis & Suicide Hotline

  collaborator OTHER

• University of Washington

  collaborator OTHER

• Columbia University

  collaborator OTHER

• University of Pennsylvania

  collaborator OTHER

• St. Luke's Health System, Boise, Idaho

  lead OTHER

Principal Investigators

• Anna K Radin, DrPH, MPH · St. Luke's Health System

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

12 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-05-20

Primary Completion

2024-07-07

Completion

2024-07-07

Countries

• United States

Study Locations