About this trial

The goal of this study is to test an enhanced outreach intervention (EOI) delivered by Samaritans of Boston (a community organization that provides support during mental health crises) for people after they leave an emergency department (ED) visit for suicidal thoughts. The main questions it aims to answer are:

* Does the EOI reduce suicide-related behaviors? * Does the EOI increase outpatient treatment attendance? * Is the EOI acceptable and feasible? * Can the EOI be delivered with fidelity by Samaritans?

Participants will be randomized to the EOI plus care as usual or care as usual alone. Participants in the EOI plus care as usual group will:

* Receive outreach (by call or text) at a planned time once per week for the next 12 weeks. During these conversations, Samaritans staff will ask participants questions about their suicidal thoughts and behaviors, develop and review a list of coping skills to use if they have suicidal thoughts, and discuss plans for receiving mental health care. * Receive caring messages from Samaritans staff at least once per week. * Receive standard care that hospitals give for patients who present with suicidal thoughts. * Be asked to complete monthly self-report questionnaires.

For care as usual alone, participants will:

* Receive standard care that hospitals give for patients who present with suicidal thoughts. * Be asked to complete monthly self-report questionnaires.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Currently a patient being treated and evaluated by psychiatry service in an MGB ED

Participants enrolled in another study (NCT05671133; PI Nock) conducted by the research team who fall into the top 50% of risk based on the suicide risk prediction algorithm used in that study

Able to read English

Ownership of a smartphone (iOS or Android) and consistent access to their smartphone following discharge from the current treatment unit or program; ability to be reliably contacted

Disqualifiers

Any factor that impairs an individual's ability to comprehend and effectively participate in informed consent, including the presence of gross cognitive impairment due to florid psychosis, intellectual disability, dementia, or acute intoxication

Presence of extremely agitated or violent behavior at the time of consent or enrollment

Trial design

Design model

Parallel

Treatments tested in this trial

Enhanced Outreach Intervention (EOI) plus Care as Usual (CAU)
Behavioral
The EOI will contain four main components: safety planning, caring contacts, care engagement, and risk assessment. Outreach (via phone or text messaging) from Samaritans staff will be conducted every week of the 12 week intervention. Conversations will use a standardized phone script to (a) conduct a risk assessment, (b) develop and review a list of coping skills to use if the participant has suicidal thoughts, and (c) discuss plans for receiving mental health care. Samaritans staff will also send a caring text message or email at least once per week. Participants will also receive standard care that hospitals provide to patients who present with suicidal thoughts.
Care as Usual (CAU)
Other intervention
Participants will receive standard care that hospitals provide to patients who present with suicidal thoughts.

Treatment groups

300 Participants

are divided into 2 treatment groups

Group A: Enhanced Outreach Intervention plus Care as Usual (CAU)Experimental treatment 1 intervention

Group B: Care as Usual (CAU)Other 1 intervention

Trial outcomes

Primary outcomes

1

Number of Suicide Attempts

Whether or not a suicide attempt occurs during the 12-week intervention period will be captured by manual review of electronic health records and the Self-Injurious Thoughts \& Behaviors Interview (SITBI).

Time frame

4 weeks

2

Number of Suicide Attempts

Whether or not a suicide attempt occurs during the 12-week intervention period will be captured by manual review of electronic health records and the Self-Injurious Thoughts \& Behaviors Interview (SITBI).

Time frame

8 weeks

3

Number of Suicide Attempts

Whether or not a suicide attempt occurs during the 12-week intervention period will be captured by manual review of electronic health records and the Self-Injurious Thoughts \& Behaviors Interview (SITBI).

Time frame

12 weeks

Secondary outcomes

1

Treatment Attendance

Treatment attendance during the 12-week intervention period will be captured by manual review of electronic health records and participant-reported outcome survey.

Time frame

4 weeks, 8 weeks, and 12 weeks

2

Depressive Symptoms

Depressive symptoms will be measured using the Patient Health Questionnaire-9 (PHQ-9). The scale values ranges from 0 to 3. Higher total scores mean more severe symptoms.

Time frame

Baseline, 4 weeks, 8 weeks, and 12 weeks

3

Intensity of Suicidal Ideation

The intensity of suicidal ideation will be measured using the Beck Scale for Suicide Ideation (BSS). The scale values ranges from 0 to 2. Higher scores mean more intense suicidal ideation.

Time frame

Baseline, 4 weeks, 8 weeks, and 12 weeks

Locations

This trial has no locations.

A Health System/Community Partnership for Enhanced Outreach to Prevent Suicide Attempts

About this trial

Eligibility criteria

Qualifiers

Disqualifiers

Trial design

Treatments tested in this trial

Treatment groups

Trial outcomes

Primary outcomes

Secondary outcomes

Other outcomes

Locations

Sponsors and contacts