Walter Kristen H, Khandekar Pia R, Kline Alexander C, Miggantz Erin L, Otis Nicholas P, Glassman Lisa H, Thomsen Cynthia J, Brock Guy, Bryan Craig J
Psychological Health & Readiness, Naval Health Research Center, San Diego, CA, USA.
Innovative Employee Solutions, San Diego, CA, USA.
Contemp Clin Trials Commun. 2024 Dec 6;42:101407. doi: 10.1016/j.conctc.2024.101407. eCollection 2024 Dec.
Suicide is one of the leading causes of death among U.S. service members, and rates of suicide among military personnel have increased over the past two decades. To address this serious issue, effective preventive treatments are needed in settings where at-risk service members are frequently seen, such as emergency departments and inpatient psychiatric units. This study will compare the longitudinal effects of crisis response planning (CRP) and treatment as usual (TAU) on suicidal thoughts and behaviors among active duty service members seeking emergent care for suicidality at a military treatment facility.
The current study is conducted through a consortium, Augmenting Suicide Prevention Interventions for Service Members. This article details an ongoing stepped-wedge cluster randomized clinical trial that compares rates of suicidal thoughts and behaviors among service members at risk for suicide following care from CRP-trained providers versus untrained providers (i.e., TAU). Participants complete assessments at pretreatment and every 3 months up to 1 year. Primary outcomes include suicide attempts and behaviors, and suicidal ideation is a secondary outcome. Moderators of treatment effects will also be examined. The methodological development of this trial is discussed, along with clinical and ethical considerations for suicide prevention research in emergency, inpatient, and military treatment settings.
Providing evidence-based treatment for suicidality that addresses service members' unique needs is crucial to reduce suicide rates and facilitate mental health recovery in this population. This study aims to inform future implementation and dissemination of CRP in healthcare systems to ultimately decrease suicide among service members.
NCT05795764.
自杀是美国现役军人的主要死因之一，在过去二十年中，军事人员的自杀率有所上升。为了解决这一严重问题，在急诊室和住院精神科等经常能见到有自杀风险的现役军人的场所，需要有效的预防性治疗。本研究将比较危机应对计划（CRP）和常规治疗（TAU）对在军事治疗机构因自杀倾向寻求紧急护理的现役军人自杀想法和行为的长期影响。
本研究通过一个名为“增强军人自杀预防干预措施”的联盟进行。本文详细介绍了一项正在进行的阶梯式楔形整群随机临床试验，该试验比较了接受CRP培训的提供者与未接受培训的提供者（即TAU）护理后有自杀风险的军人的自杀想法和行为发生率。参与者在治疗前以及治疗后每3个月进行一次评估，持续1年。主要结局包括自杀未遂和行为，自杀意念是次要结局。还将研究治疗效果的调节因素。讨论了该试验的方法学发展，以及在急诊、住院和军事治疗环境中进行自杀预防研究的临床和伦理考虑因素。
为自杀倾向提供基于证据的治疗，以满足军人的独特需求，对于降低该人群的自杀率和促进心理健康恢复至关重要。本研究旨在为未来CRP在医疗系统中的实施和推广提供信息，以最终减少军人中的自杀行为。
NCT05795764。
