Mental Health Resiliency Intervention for Suicide Prevention in Nurses

Overseen By Bernadette Melnyk, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Disqualifiers: Low suicide risk, Under 18, Prior participation, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: 8 weeks

849 Participants Needed

Trial Summary

What is the purpose of this trial?

The overall purpose of this study is to evaluate the efficacy of an intervention designed to prevent nurse suicide. This randomized controlled trial will test the modified Interactive Screening Program (mISP) alone and the mISP combined with a program called MINDBODYSTRONG. The mISP is a method of screening to detect clinicians at moderate to high risk for suicide and referring them for treatment through an encrypted anonymous on-line platform. MINDBODYSTRONG© is an adaptation of a well-tested cognitive-behavioral skills building intervention (also known as COPE in the literature) that provides a cognitive-behavior theory-based approach to decrease depression, anxiety and suicidal ideation and improve healthy lifestyle beliefs and behaviors in at-risk populations. MINDBODYSTRONG© will involve eight self-paced computerized sessions designed specifically for nurses and clinicians. Nurses will be recruited nationally through the professional nursing organizations and health systems.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment MINDBODYSTRONG™ for improving mental health in nurses?

Research shows that mindfulness-based interventions, which are part of the MINDBODYSTRONG™ program, can reduce anxiety, depression, and stress in nurses, and slightly improve their overall well-being. ^{1 2 3 4 5}

Is the Mental Health Resiliency Intervention for Suicide Prevention in Nurses safe?

Mindfulness-based interventions, similar to the ones used in the Mental Health Resiliency Intervention, have been shown to be safe and beneficial for nurses, improving mental health and well-being without reported adverse effects. ^{2 3 6 7 8}

What makes the MINDBODYSTRONG treatment unique for suicide prevention in nurses?

MINDBODYSTRONG is unique because it combines cognitive-behavioral skills with a focus on resilience, insight, self-compassion, and empowerment, specifically tailored for nurses to improve mental health and prevent burnout, which are key factors in suicide prevention. ^{1 2 5 6 9}

Eligibility Criteria

This trial is for registered nurses who are at moderate to high risk of suicide, as identified by the HEAR-specific interactive screening program. Nurses must self-identify as such and be recognized nationally through the American Nurses Association.

Inclusion Criteria

Self-identify as a registered nurse

Identified as moderate to high risk of suicide by the HEAR-specific interactive screening program assignment

Exclusion Criteria

Low risk of suicide by the HEAR-specific interactive screening program assignment.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the mISP and/or MINDBODYSTRONG© intervention, including 8 self-paced computerized sessions and weekly reminders

8 weeks

Weekly virtual check-ins

Follow-up

Participants are monitored for changes in anxiety, depression, suicidal ideation, and other mental health outcomes

12 months

Follow-up surveys at 3, 6, and 12 months

Treatment Details

Interventions

• MINDBODYSTRONG™

Trial Overview The study is testing two approaches: one group will use the HEAR program alone, which screens and refers clinicians for treatment anonymously online; another group will combine HEAR with MINDBODYSTRONG©, a cognitive-behavioral intervention with eight sessions designed to reduce depression and suicidal thoughts.

Participant Groups

Group I: mISP Active Control 1 Intervention

Participants who are identified as having moderate to high risk of suicide, as identified by suicide risk on the ISP, will be contacted by a mental health counselor who will engage them through the mISP encrypted interface online. The mental health counselor will offer counseling online through encryption or on the phone. Where indicated, the mental health counselor will provide the crisis hotline, and encourage participants to use their insurance provider and/or Employee Assistance Program to obtain treatment. The mental health counselor will offer to help with referrals and will bridge high-risk participants into treatment. Participants who are not identified as having moderate to high risk of suicide will be thanked for their time.

Group II: mISP plus MINDSTRONG Active Control 1 Intervention

Participants identified as having a moderate to high risk of suicide based on ISP screening will then be randomized. Participants randomized to the MINDBODYSTRONG© program (intervention) will receive the 8-session online interactive program. Reminders will be sent weekly to complete the next MINDBODYSTRONG© session and a MINDBODYSTRONG© trained coach will check in with participants by phone at baseline, weeks 3 and 5 of the on-line program to reinforce key program concepts and assess whether participants are completing the weekly skills building activities. Nurses assigned to the control group will only receive the mISP alone (aforementioned) and will be contacted for follow-up surveys.

MINDBODYSTRONG™ is already approved in United States for the following indications:

Approved in United States as MINDBODYSTRONG for:

• Prevention of nurse suicide
• Reduction of depression
• Reduction of anxiety
• Reduction of suicidal ideation
• Improvement of healthy lifestyle beliefs and behaviors

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

American Foundation for Suicide Prevention

Collaborator

Trials

36

Recruited

10,500+

University of San Diego

Collaborator

Trials

6

Recruited

11,100+

Findings from Research

The MINDBODYSTRONG program significantly improved healthy lifestyle beliefs and behaviors among 100 hospital personnel, including 93 nurses, indicating its effectiveness in promoting overall well-being.

Participants experienced significant reductions in anxiety, depression, stress, and burnout after completing the program, especially those who initially reported higher levels of these issues, highlighting its potential to enhance mental health in healthcare settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees. Hoying, J., Terry, A., Kelly, S., et al.[2023]

The RISE intervention, which stands for resilience, insight, self-compassion, and empowerment, is designed to improve mental health and well-being among nurses by addressing stress, burnout, and compassion fatigue through eight psychoeducational group sessions.

Based on a combination of mindfulness, acceptance and commitment therapy, and cognitive-behavioral therapy, RISE aims to provide nurses with effective coping strategies and support, contributing to the literature on interventions that enhance well-being in high-stress healthcare environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Psychoeducational Group Intervention for Nurses: Rationale, Theoretical Framework, and Development. Bailey, AK., Sawyer, AT., Robinson, PS.[2023]

Mindfulness-based interventions (MBIs) significantly reduced psychological distress, including anxiety and depression, in nurses, with a standardized mean difference of -0.47 based on a meta-analysis of nine randomized controlled trials involving 572 participants.

MBIs also showed a slight improvement in psychological wellbeing, such as resilience and quality of life, with a standardized mean difference of 0.28, although they did not significantly impact job-related outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Mindfulness-Based Interventions on Mental Health in Nurses: A Meta-Analysis of Randomized Controlled Trials. Kang, MJ., Myung, SK.[2022]

A randomized controlled trial involving 118 psychiatric nurses showed that an 8-week guided self-help mindfulness intervention significantly increased mindfulness and psychological resilience while reducing job burnout compared to a control group that received only a psycho-educational brochure.

The results suggest that guided self-help mindfulness interventions are effective and accessible methods for improving mental health and well-being among psychiatric nurses working in high-stress environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. Wang, Q., Luan, Y., Liu, D., et al.[2023]

A study analyzing 1,358 nurses who died by suicide revealed that mental health issues, substance use, chronic pain, and bereavement were common factors, highlighting the complex interplay of these issues in their lives.

The findings emphasize the urgent need to reduce stigma around mental health in nursing and improve access to mental health support, suggesting that integrated healthcare approaches could help lower suicide rates among nurses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Entangled: A mixed method analysis of nurses with mental health problems who die by suicide. Barnes, A., Ye, GY., Ayers, C., et al.[2023]

The article outlines 14 strategies aimed at protecting and promoting the mental health of nurses, highlighting the importance of mental well-being in the nursing profession.

Implementing these strategies can help mitigate stress and burnout among nurses, ultimately leading to better patient care and improved workplace environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caring for COVID's emotional long haulers. Tye, J., Long, K., Blake, N., et al.[2023]

An eight-week online mindfulness program significantly reduced perceived stress, anxiety, and depression among nursing professionals during the COVID-19 pandemic, with a treatment adherence rate of 70.12%.

Participants reported increased mindfulness and overall satisfaction with their lives and work, indicating that mindfulness-based interventions are effective for promoting mental health and self-care in healthcare workers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic. Gherardi-Donato, ECDS., Díaz-Serrano, KV., Barbosa, MR., et al.[2023]

The telephonic Mindfulness-Based Stress Reduction (tMBSR) program significantly improved nurses' health, reduced stress, and decreased burnout over an 8-week period, with effects lasting for at least 4 months after the intervention.

This innovative delivery method makes MBSR more accessible and scalable for healthcare workers, providing a low-cost alternative to traditional in-person sessions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting. Bazarko, D., Cate, RA., Azocar, F., et al.[2022]

A study involving women aged 20 to 64 at a Primary Care Unit showed that mental health promotion activities led to significant improvements in physical and environmental quality of life, as measured by various questionnaires.

The use of ludic activities and the Body Mapping technique proved effective in enhancing specific aspects of quality of life, highlighting their potential as valuable tools for nursing interventions in mental health care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promotion of women's mental health: the influence of physical health and the environment. Souza, J., Oliveira, JL., Oliveira, JLG., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

A cognitive-behavioral skills building program improves mental health and enhances healthy lifestyle behaviors in nurses and other hospital employees. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

A Psychoeducational Group Intervention for Nurses: Rationale, Theoretical Framework, and Development. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Effects of Mindfulness-Based Interventions on Mental Health in Nurses: A Meta-Analysis of Randomized Controlled Trials. [2022]

4. Australia pubmed.ncbi.nlm.nih.gov

Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial. [2023]

5. Australia pubmed.ncbi.nlm.nih.gov

Entangled: A mixed method analysis of nurses with mental health problems who die by suicide. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Caring for COVID's emotional long haulers. [2023]

7. Switzerland pubmed.ncbi.nlm.nih.gov

The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting. [2022]

9. Brazil pubmed.ncbi.nlm.nih.gov

Promotion of women's mental health: the influence of physical health and the environment. [2020]