Peer Counseling for Suicide Prevention

Overseen By Claire Houtsma, PhD

Age: 18+

Sex: Any

Trial Phase: Phase 1 & 2

Sponsor: VA Office of Research and Development

Disqualifiers: Active psychosis, Insufficient English, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores new methods to prevent suicide among Veterans by focusing on firearm storage practices. It compares two approaches: a peer-led discussion about safe firearm storage (Peer Engagement and Exploration of Responsibility and Safety) and the distribution of educational materials. The goal is to determine if peer discussions encourage Veterans to store firearms more securely, potentially reducing suicide risk. Veterans who own firearms and do not consistently store them securely may be suitable for this trial. Participants must be able to join virtual meetings online. As a Phase 1 and Phase 2 trial, this research aims to understand the peer-led approach and measure its effectiveness in an initial group, offering participants a chance to contribute to innovative suicide prevention strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on secure firearm storage and does not mention medication changes.

What prior data suggests that this protocol is safe for Veterans?

Research has shown that the Peer Engagement and Exploration of Responsibility and Safety (PEERS) program helps Veterans store firearms more safely. This approach involves Veterans discussing the benefits of secure storage with each other.

No specific data on negative effects have emerged from these studies, which is encouraging. Since this program is not a drug or medical procedure, it is likely easy to manage. It primarily focuses on conversations and information sharing.

As this trial remains in the early stages, safety and effectiveness continue to be studied. However, many Veterans prefer the peer-led approach, indicating it is comfortable and acceptable for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Peer Engagement and Exploration of Responsibility and Safety (PEERS) intervention because it offers a fresh approach to suicide prevention by leveraging peer support among veterans. Unlike traditional treatments that often rely solely on professional counseling or medication, PEERS involves veterans supporting each other, potentially creating a deeper sense of understanding and connection. This peer-based method aims to increase engagement and personal responsibility, offering a complementary strategy to existing psychoeducational approaches, which typically focus on educating individuals about safety without peer interaction. This innovative peer-driven model may provide a more relatable and supportive environment for veterans, potentially leading to improved outcomes in suicide prevention.

What evidence suggests that this peer counseling intervention is effective for suicide prevention?

Research has shown that safely storing firearms can greatly reduce the risk of suicide among Veterans. This trial will compare two approaches: the Peer Engagement and Exploration of Responsibility and Safety (PEERS) program and an active control group. Studies have found that programs like PEERS, where Veterans assist each other, show promise in promoting safer storage habits. Experts believe the PEERS program suits Veterans well and can be effectively managed by fellow Veterans. Early results suggest that these peer-led programs are practical and can lead to positive behavior changes. This method not only helps prevent suicide but also reaches Veterans outside regular healthcare settings. ^{2 6 7 8 9}

Who Is on the Research Team?

Claire Houtsma, PhD

Principal Investigator

Southeast Louisiana Veterans Health Care System, New Orleans, LA

Are You a Good Fit for This Trial?

This trial is for Veterans who may benefit from secure firearm storage to prevent suicide. Participants will engage in a peer-to-peer discussion about safe gun storage practices. The study excludes individuals based on criteria not specified here.

Inclusion Criteria

Capable of meeting via virtual modalities for appointments (i.e., owns a device capable of connecting for virtual appointments, has internet access)

Veteran

Owns at least one personal firearm

Exclusion Criteria

Insufficient English language skills

No reliable access to a telephone and/or device for attending appointments via virtual modalities

Active psychosis

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

Eligibility Screening

Intervention

Participants engage in a 15-60 minute peer-delivered Lethal Means Counseling session focused on secure firearm storage

1 hour or less

1 visit (in-person or virtual)

Follow-up

Participants are monitored for changes in secure firearm storage practices and other related measures

1 year

Follow-ups at 1-week, 6-months, and 1-year

What Are the Treatments Tested in This Trial?

Interventions

• Peer Engagement and Exploration of Responsibility and Safety

Trial Overview The effectiveness of a peer-delivered intervention called Peer Engagement and Exploration of Responsibility and Safety (PEERS) is being tested against just receiving psychoeducational materials. It focuses on promoting secure firearm storage among Veterans.

How Is the Trial Designed?

Group I: PEERS Experimental Treatment 1 Intervention

Veterans in this condition will complete the PEERS intervention and will receive the same psychoeducational materials as the active control group.

Group II: Active Control Experimental Treatment 1 Intervention

Veterans in this condition will receive psychoeducational materials on lethal means safety and will have NO interaction with peers.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12203803/

Development of a peer-delivered lethal means counseling ... This study aimed to adapt and expand an evidence-based lethal means counseling intervention for peer-delivery among firearm owning Veterans.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9165581/

Peer-based interventions targeting suicide prevention The aim of the current study is to conduct a scoping review to characterize the breadth of peer-delivered suicide prevention services and their outcomes.

3. researchgate.net researchgate.net/publication/385940766_Development_of_a_peer-delivered_lethal_means_counseling_intervention_for_firearm_owning_veterans_Peer_engagement_and_exploration_of_responsibility_and_safety_PEERS

Development of a peer-delivered lethal means counseling ... Experts rated the appropriateness of the adapted intervention, named Peer Engagement and Exploration of Responsibility and Safety (PEERS), and associated ...

4. researchprotocols.org researchprotocols.org/2025/1/e66182

A Recovery-Oriented Suicide Prevention Program Led by ... Objective: We detail a pilot randomized controlled trial protocol evaluating a novel peer specialist–delivered suicide prevention intervention ...

5. psychiatryonline.org psychiatryonline.org/doi/full/10.1176/appi.ps.202100561

Feasibility of Peer-Delivered Suicide Safety Planning in the ... Peer-delivered safety planning is feasible and acceptable and may result in fewer return ED visits. These findings provide preliminary support for peer- ...

6. researchwithrutgers.com researchwithrutgers.com/en/publications/development-of-a-peer-delivered-lethal-means-counseling-intervent

Development of a peer-delivered lethal means counseling ... Introduction: This study aimed to adapt and expand an evidence-based lethal means counseling intervention for peer-delivery among firearm owning Veterans.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT07033884

Reducing Firearm Suicide Among Veterans: Evaluating the ... The resulting intervention, Peer Engagement and Exploration of Responsibility and Safety (PEERS), is a 15-60 minute one-on-one LMC session centered around ...

8. rand.org rand.org/pubs/perspectives/PEA1363-1-v2.html

Suicide Among Veterans Peer Engagement and Exploration of Responsibility and Safety (PEERS) is a peer-delivered intervention program that promotes lethal means ...

9. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39558811/

Development of a peer-delivered lethal means counseling ... This study aimed to adapt and expand an evidence-based lethal means counseling intervention for peer-delivery among firearm owning Veterans.