BIC Program for Suicidal Ideation

(BIC Trial)

Overseen By Jaqueline Hudson, BA

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: St. Joseph's Healthcare Hamilton

Disqualifiers: Non-English speakers

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

Compensation: Varies

Number of Visits: 1

Duration: 6 months

220 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine how brief interventions, such as text messages and phone calls, can reduce suicidal thoughts and behaviors in individuals recently discharged from the hospital after a suicide attempt. The study follows the Brief Intervention and Contact (BIC) model, based on the World Health Organization (WHO), which has shown promise in reducing further suicide attempts and self-harm. Participants will receive additional support contacts over six months, alongside their usual treatment. The trial seeks individuals admitted after a suicide attempt or with suicidal thoughts who can understand English. As an unphased trial, it offers participants the chance to contribute to important research that could enhance support for others in similar situations.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this BIC program is safe for individuals with suicidal ideation?

Research has shown that Brief Intervention and Contact (BIC) treatments are generally safe. Studies have found that BIC can reduce suicidal thoughts and feelings of hopelessness without major side effects or negative reactions.

The BIC method includes short educational sessions about suicidal behavior and regular follow-up contacts after discharge. Based on a World Health Organization plan, this approach has been successfully used in various locations to support people at risk of suicide. Since BIC primarily involves talking and support, it is considered manageable. Participants typically find the intervention helpful rather than harmful.

In summary, BIC treatments are safe and can benefit those who have experienced suicidal thoughts or behavior. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Brief Intervention and Contact (BIC) program for suicidal ideation because it offers a proactive and continuous support approach, unlike traditional treatments that focus mainly on immediate post-crisis care. While standard options often include medication and psychotherapy, BIC emphasizes ongoing follow-up through scheduled contact over six months, aiming to provide consistent support and prevent future crises. This method could potentially enhance patient outcomes by maintaining regular communication and monitoring, which is not typically part of usual care strategies.

What evidence suggests that the BIC program is effective for reducing suicidal behavior?

Research has shown that Brief Intervention and Contact (BIC), which participants in this trial may receive, can help reduce suicide deaths. One study found that only 0.2% of people who received BIC died by suicide, compared to 2.2% of those who received the usual treatment. This suggests that BIC can significantly lower suicide rates. While some studies have mixed results, others have found that BIC can reduce suicidal thoughts and help individuals stay engaged in treatment. Overall, BIC appears to be a promising method to support individuals after a suicide attempt. ^{2 6 7 8 9}

Who Is on the Research Team?

Zainab Samaan, MD/PhD

Principal Investigator

McMaster Unversity

Are You a Good Fit for This Trial?

This trial is for individuals in Canada who are at least 16 years old, have been admitted due to suicidal behavior or ideation, and can provide consent. They must be able to understand English, share their health card number, and allow access to their medical records.

Inclusion Criteria

Provide written, informed consent

Provide consent for research staff to have access to their electronic medical record (EMR)

Admitted following a suicidal behaviour (suicide attempt or with suicidal ideation)

Exclusion Criteria

I understand both written and spoken English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive brief education about suicidal behaviour and follow-up contacts for 6 months in addition to treatment as usual

6 months

Follow-up at weeks 1, 2, 4, 6, 8, 12, 16, and 20

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Brief Intervention and Contact (BIC) based on Word Health Organization (WHO)

Trial Overview The study tests a Brief Intervention and Contact (BIC) program based on WHO guidelines. It involves follow-up with patients through messages, calls, and letters after discharge from the hospital to reduce suicide attempts.

How Is the Trial Designed?

Group I: Intervention Arm - Brief Intervention & Contact Experimental Treatment 1 Intervention

Brief education about suicidal behaviour and follow up contacts for 6 months in addition to treatment as usual. follow up will occur at the following time points post discharge: weeks 1, 2, 4, 6, 8, 12, 16 and 20. this will occur in addition to treatment as usual.

Group II: Control Active Control 1 Intervention

Control will continue treatment as usual which is whatever the clinical team decides upon post discharge. Data will be collected on repeated suicidal behaviour through medical records with consent.

Who Is Running the Clinical Trial?

St. Joseph's Healthcare Hamilton

Lead Sponsor

Trials

203

Recruited

26,900+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2649494/

Effectiveness of brief intervention and contact for suicide ... Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group (0.2% versus 2.2%, respectively; χ² = 13.83, P ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT03825354

NCT03825354 | Brief Intervention and Contact (BIC) Program We hypothesize that brief intervention and contact is an effective intervention for reducing suicidal behaviour in patients who have attempted suicide. The ...

3. psychiatryonline.org psychiatryonline.org/doi/full/10.1176/appi.focus.20220083

Brief and Ultra-Brief Suicide-Specific Interventions | Focus In adult populations, CAMS has demonstrated effectiveness in reducing suicidal ideation and overall symptom distress, compared with treatment as ...

4. ctu.dk ctu.dk/wp-content/uploads/2024/04/Masterarbeit_Pascal_Faltermeier_Psychologie_KPP_Nach_PsychThG_2019_SS22.pdf

Meta-Analysis of brief contact interventions to prevent ... Meta- analysis showed no evidence of a beneficial effect on suicide attempts compared to control interventions (risk ratio (RR) 0.87; 95% CI 0.72 to 1.05; p < ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2949875923002072

Pilot randomized controlled trial of a brief strategy to ... (2022) found the intervention appeared to decrease suicidal ideation and improve treatment engagement. The VA BIC intervention, however, has not been studied in ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8955571/

A virtual, pilot randomized trial of a brief intervention to ... ... BIC may be associated with improvements in suicidal ideation and hopelessness. These results align with the limited body of research on brief suicide prevention ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12080141/

Brief interventions for suicidal ideation in primary care This systematic review seeks to identify, compare, and critically evaluate effective brief interventions for managing suicidality in primary care.

8. psychiatryonline.org psychiatryonline.org/doi/10.1176/appi.ps.202000537

A Pilot Randomized Trial of a Brief Intervention to Prevent ... At 1 month, the VA BIC had a medium effect on suicidal ideation (Hedges' g=0.45) and a large effect on thwarted belongingness (g=1.23, p<0.05) ...

9. publications.aap.org publications.aap.org/pediatrics/article/153/3/e2023061881/196630/Brief-Interventions-for-Suicidal-Youths-in-Medical

Brief Interventions for Suicidal Youths in Medical Settings Brief suicide interventions for youth in outpatient medical settings can increase identification of risk, increase access to behavioral health services,