Category: Suicide and Self-Injury

Symposium

Pragmatic Effectiveness Trials for Suicide-Focused Psychosocial Interventions

Friday, November 17
1:45 PM - 3:15 PM
Location: Cobalt 502, Level 5, Cobalt Level

Keywords: Suicide | Military
Presentation Type: Symposium

Background: Standard behavioral health services offered to suicidal clients in real-world clinics are dominated by treatments for diagnostic conditions such as depression or bipolar disorder or by risk assessment and management strategies.  However, randomized clinical trials have shown the psychosocial interventions focused specifically on suicidality are more efficacious.  Thus, it is critical that pragmatic trials of suicide-focused psychosocial interventions are conducted to determine which interventions are effective in the real-world settings in which they are needed. 


Methods: Study 1 was a randomized controlled trial comparing the use of the Collaborative Assessment and Management of Suicidality (CAMS) to enhanced care as usual. Study participants were 148 active duty Soldiers who presented to a military outpatient behavioral health clinic. Suicide and health service outcomes were measured through assessments taken at baseline and at 1, 3, 6, and 12 months post-baseline. Study 2 was a randomized controlled trial comparing usual care alone to usual care augmented with caring contacts via text message.  Participants were 658 active duty male and female Soldiers and Marines, who were identified as suicidal. Participants in the caring contacts condition receive text messages. Suicide and health service outcomes were measured through assessments taken at baseline and 12 months post-baseline. 


Results:Soldiers in both arms of Study 1 responded to study treatments in terms of all primary and secondary outcomes (effect sizes ranged from 0.63 to 12.04). CAMS participants were significantly less likely to have any suicidal thoughts in comparison to those in care as usual (p=.028).  Study 2 recruitment has been completed and final 12 month data collection will be completed by Sept 2017. Caring contacts via text message is both feasible and acceptable to study participants and partner clinicians.


Conclusions:These trials will be put in the context of civilian on-going and completed pragmatic clinical trials leading to conclusions about what interventions are effective and feasible to resolve suicidality in real-world settings.

Katherine Comtois

University of Washington

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