Integrated Intervention for Caregivers--Open Trial
Distress; MaternalSelf-Efficacy2 moreAdolescents who have been hospitalized for suicidal behavior are at risk for engaging in additional suicidal behavior. After hospitalization, parents or guardians are typically asked to be responsible for helping to prevent further suicidal behavior. This can include monitoring the youth, making sure the home is safe, getting the youth any needed treatment, and balancing the parents' expectations of the youth with the understanding that the youth is in a vulnerable state. Even with these efforts by parents, adolescents often have additional crisis situations. The goal of this study is to develop and test an integrated electronic and care support service intervention for parents of suicidal youth. It is expected that this intervention will help parents/guardians in the roles of caring for suicidal youth after discharge from the hospital. This open trial will assess the feasibility of this intervention for a separate pilot randomized controlled trial to compare the intervention to enhanced treatment as usual.
Increasing Treatment Seeking Among Suicidal Veterans Calling the Crisis Line
SuicideThe goal of this research plan is to test the effectiveness of a brief, cognitive behavioral (CB) intervention to promote behavioral health treatment engagement among at-risk Veterans who call the Crisis Line but are resistant to behavioral health services.
Ecological Momentary Mental Assessment
Person at Risk of SuicideSuicide is a major health problem that causes annually a million death worldwide. Suicide and suicide attempts are preventable. A history of self-injuries or suicidal attempts are known to be the most important risk factor for death by suicide. Suicidal ideation is also strongly correlated with suicide attempts. The development of Smartphones applications offers new possibilities for data collection and transmission. Moreover, the online help function, when a suicidal crisis occurs, is the most effective strategy for prevention of suicidal behavior. Specific technologies have been developed to analyse behaviors and experiences of patients in a natural environment, in real life. That is the goal of Ecological Momentary Assessment. The aim of the study is to develop an algorithm to assess and predict the risk of suicidal event occurrence, in order to detect as soon as possible the signs of suicidal crisis. EMMA will be the first application in French, meeting the recommendations for health applications, developed by experts on suicidal behavior and in collaboration with patients which aims to predict suicidal risk. A subsequent study, conducted on a larger population, should allow to validate the predictive algorithm of EMMA. Long-term goal is to improve the care of patients at risk for suicidal behavior.
Developing and Implementing an Adolescent Suicide Prevention Program in a Community Mental Health...
SuicideAttempted1 moreThis is a three phase study to develop and implement an adolescent suicide prevention program in a community mental health setting. In Phase 1, needs assessments using qualitative interviews will be conducted at in a community mental health clinic with suicidal teens and their parents, and with community experts including therapy staff who serve patients at a community mental health clinic. In Phase 2, the investigators will develop a new treatment manual that is guided by information obtained in the previously completed needs assessment. The investigators will pilot the program with one group of adolescents (N=10), and make iterative revisions based on feedback. Training sessions will be implemented. In Phase 3, the investigators will conduct an open trial of a group for 40 adolescents at the community mental health clinic to assess feasibility of recruitment, implementation, satisfaction, and outcome. Program outcomes will be utilization, patient and family satisfaction ratings, and improvement in depression and suicide risk measures at discharge from the program and at one month and six months follow-up. In addition, rate of suicidal events (suicide attempt, hospitalization) at one month and six months post-discharge will be compared to historical controls.
Increasing Help-Seeking Behavior Among Transitioning Veterans at Risk for Suicide With Online Gatekeeper...
Suicide PreventionThe purpose of this study is to evaluate the feasibility and acceptability of a gatekeeper training called PsychArmor S.A.V.E. which was developed through a partnership between the VA and the PsychArmor Training Institute. Gatekeeper training teaches "gatekeepers" skills in how to identify a person with suicide risk, inquire about suicidal thoughts, and help make a connection to professional treatment. PsychArmor S.A.V.E. is a brief, novel online gatekeeper training that was created and designed specifically for Veterans and their family and friends. In this study, the investigators will recruit Veterans who have recently transitioned out of the military, as well as their family and friends. Participants in the study will be asked to complete a survey, watch the PsychArmor S.A.V.E. training, and complete several follow-up surveys over six months. A small subset of participants will also be invited to participate in an interview.
The Effects of Regular Mountain Hiking on Hopelessness in Chronically Suicidal Patients
SuicideHopelessnessSuicide is a major public health issue with estimated 1 million deaths worldwide within the last year. Physical activity and nature recreation might be protective factors against suicidal behaviour, suicidal ideation and contributing factors like depression and hopelessness. In this randomized controlled cross-over intervention study the investigators aim to investigate the physical and psychological effects of a 9 weeks hiking program in chronically suicidal patients. The investigators aim to enroll 24 patients suffering from chronic suicidality, defined as at least one attempted suicide and a hopelessness greater than 26 in Beck's Hopelessness Scale summary score. At baseline patients will undergo pre-tests including questionnaires to assess suicide ideation, hopelessness, depression, anxiety, quality of life and health-related physical activity, physiological investigations to assess exercise capacity and blood investigations. Randomly assigned 12 patients start with the 9 weeks supervised mountain hiking program followed by a 9-week-period without supervised exercise program. The other 12 patients start with 9 weeks without supervised exercise program followed by a 9-week-period of supervised mountain hiking program. The mountain hiking program includes 2 training sessions per week with a duration of 3 hours per session. The hiking intervention will be performed within 70-85% of heart rate reserve and gymnastics for body and nature perception, mobilisation and stretching will enrich the training program. Further investigations including questionnaire-assessments, assessment of exercise capacity and blood investigations will be scheduled 9 and 18 weeks after the study start. In addition a daily assessment of several suicide risk-factors based on a web-based questionnaire will be done over the full study period. Within this mountain hiking program the investigators hope to reduce hopelessness in chronically suicidal patients.
Increasing Help-Seeking in Military Service Members
Military Service Members at Elevated Suicide RiskThere is sufficient evidence that military service members markedly underutilize behavioral health care services, in part, due to stigma. This study proposes to examine a novel application of a cognitive bias modification (CBM) intervention designed to target stigma-related cognitions among service members at elevated suicide risk not currently engaged in behavioral health treatment.
Beneficial and Harmful Effects of Reducing Public Suicide Stigma
Public Suicide StigmaThere is growing evidence that negative attitudes towards persons affected by suicide (i.e. persons who experience suicidality, persons who lost a loved one to suicide), so called public suicide stigma, is harmful for suicide prevention, for example by reducing social support, inhibiting help-seeking for suicidality and increasing distress as well as suicidality among stigmatized persons. Reducing public suicide stigma could therefore be an important factor of successful suicide prevention. However, reducing public suicide stigma could also be harmful, for example by increasing attitudes that suicidal behaviour is a normal and acceptable solution for crisis situations, which could decrease help-seeking for suicidality and encourage suicidal behaviour. This project will (1) develop four interventions (contact-based vs. education based, video vs. text) hypothesized to reduce public suicide stigma, (2) determine the efficacy of the four interventions with regard to reducing public suicide stigma, (3) identify additional harmful (e.g. normalization of suicidal behaviour) and beneficial intervention effects (e.g. improved attitudes to seek help) and (4) investigate pathways explaining intervention effects.
Breaking Down Barriers to a Suicide Prevention Helpline
Suicidal IdeationEvery month, around four thousand people fill in the anonymous self-test for suicidal thoughts on the website of the Dutch suicide prevention helpline 113 Suicide Prevention. The self-test includes the Suicidal Ideation Attributes Scale (SIDAS) and informs people about the severity of their suicidal thoughts. The vast majority (70%) of people who complete the test score higher than the cut-off point (≥ 21) for severe suicidal thoughts. Despite this, only around 10% of test-takers navigate to the webpage about contacting the helpline. In this study the investigators test an intervention that aims to reduce barriers to contacting the helpline via chat or phone. People with severe suicidal thoughts and little motivation to contact the helpline will be randomly allocated either to a brief Barrier Reduction Intervention (BRI) or care as usual, a plain advisory text. The aim of our study is two-fold: (i) to measure the effectiveness of a brief barrier reduction intervention (BRI) in the self-test motivating people with severe suicidal thoughts to contact the helpline, and (ii) to specifically evaluate the effectiveness of the intervention in increasing service utilisation by high-risk groups for suicide such as men and people of middle age.
PHARM-S.A.V.E.S: Suicide Prevention Training
SuicideThis is a pilot Randomized Controlled Trial (RCT) in which 150 pharmacy staff members will be randomized to an experimental or control group and data on suicide prevention communication and secondary outcomes will be collected over the course of the RCT.