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2015 HSR&D/QUERI National Conference Abstract

3186 — High Risk Suicidal Veterans: Characterizing an Inpatient Psychiatric Sample

Primack JM, Providence VAMC; Doyle RL, Providence VAMC; Nicol L, Providence VAMC; Miller IW, Providence VAMC;

Suicide is one of the leading causes of death for military personnel, and rates of military suicides now exceed civilian rates. Despite public and patient health costs associated with suicidal ideation and behavior, existing efforts have not appreciably reduced the rates of suicidal behavior in the military. Consequently, finding novel, efficacious, and acceptable methods to reduce suicide behaviors is of great military health relevance. The Veteran's Coping Long Term with Active Suicide Program (CLASP) is a unique suicide reduction program that targets high-risk patients at the time of hospital discharge, and is one of few empirically-developed and promising interventions for individuals hospitalized for suicide behavior. The primary objective of the study is to test the efficacy of CLASP in a sample of Veterans at risk for suicide behavior. CLASP will be compared to a Safety Assessment and Follow-up Evaluation (SAFE) control condition to examine the program's efficacy in reducing suicide and rehospitalization.

CLASP is a 6-month, telephone-based, adjunctive program designed for patients at risk for suicide. The intervention combines aspects of problem-solving therapy, case management, family support, and assessment. 200 adult inpatients from the Providence Veterans Affairs Medical Center will be randomly assigned to either CLASP or SAFE. Inclusion criteria are: 1) active suicidality upon hospitalization; 2) have a telephone; and 3) English language ability. Suicidality outcomes will be assessed at baseline, 3, 6, 9, and 12-month follow-up.

In this report, we will present preliminary results characterizing our sample. Changes in suicidality over time are summarized using a Psychiatric Rating Scale (PSR) from the Longitudinal Interval Follow-Up Evaluation (LIFE). Current data reveal a trend of lower suicidal ideation scores in CLASP participants than in SAFE participants across assessment points.

Current data suggest that on average, CLASP participants are less suicidal than SAFE participants at all time-points. This suggests group differences that may prove significant. We expect that this trend will persist in subsequent findings.

If results reveal improvement in CLASP participants, the study presents major implications for treatment of at-risk Veterans. First, this intervention may decrease the rate of subsequent suicide behavior and re-hospitalization. Second, CLASP may stimulate enhanced and standardized treatment of suicide within the VA by providing a model for specific content and frequency of post-hospitalization contacts.