Cultural-Social Engagement Programs for Suicidal Thoughts

Overseen By Caroline Silva, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Rochester

Disqualifiers: Psychosis, Mania, Cognitive impairment, others

Compensation: Varies

Number of Visits: 10

Duration: 10 weeks

65 Participants Needed

Trial Summary

What is the purpose of this trial?

The proposed K23 study is an intervention study using an experimental therapeutics approach. This pilot RCT asks: "Does SOCIAL-ENGAGE increase cultural-social engagement and decrease suicide risk among Spanish-speaking adults?" We will first optimize a behavioral intervention - SOCIAL ENGAGE (S-ENGAGE) - for target engagement using human-centered design approaches with Spanish-speaking adults at risk for suicide (n=5) and then conduct a pilot RCT (n=60) to test target engagement (cultural-social engagement) and clinical impact (suicide risk) of S-ENGAGE with this population. The ultimate goal is for S-ENGAGE to be offered as a suicide prevention program for Hispanics at risk for suicide.

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 a behavioral intervention, so it's best to ask the trial coordinators for more details.

What data supports the effectiveness of the treatment Social Engage (S-ENGAGE) for suicidal thoughts?

Research suggests that psychoeducation (teaching about mental health) and social support interventions can help people feel more hopeful and motivated to manage suicidal thoughts. Programs that combine education and skills training are effective in improving attitudes and reducing suicide rates. ^{1 2 3 4 5}

Is the Cultural-Social Engagement Program for Suicidal Thoughts safe for humans?

The available research on similar psychoeducation and engagement programs suggests they are generally safe, with participants reporting minimal distress and increased hopefulness after participation. These programs have been well-received and are considered feasible and acceptable in various settings. ^{1 2 4 6 7}

How is the Social Engage (S-ENGAGE) treatment different from other treatments for suicidal thoughts?

The Social Engage (S-ENGAGE) treatment is unique because it combines cultural and social engagement programs to address suicidal thoughts, focusing on community involvement and support networks, which is different from traditional medical or psychoeducational approaches that often focus solely on individual therapy or medication. ^{1 2 8 9 10}

Eligibility Criteria

This trial is for Hispanic/Latino adults over 18 who primarily speak Spanish, are part of the UR health system, feel socially isolated or lonely, and have had suicidal thoughts recently. They must not be able to engage much culturally or socially and cannot have severe medical or mental conditions that affect their ability to consent.

Inclusion Criteria

Low cultural-social engagement (i.e., score ≤ 2 on the adapted Berkman-Syme Social Network Index)

I primarily speak Spanish.

Patient in the UR health system

Exclusion Criteria

Medical or psychiatric comorbidities that impair ability to consent (e.g., active psychotic or manic episode, cognitive impairment)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Optimization

Optimization of the SOCIAL ENGAGE (S-ENGAGE) intervention using human-centered design approaches with Spanish-speaking adults at risk for suicide

Not specified

Treatment

Participants receive 10 one-hour individual sessions of S-ENGAGE over 10 weeks

10 weeks

10 visits (in-person)

Follow-up

Participants are monitored for changes in cultural-social engagement and suicide risk

4 weeks

Treatment Details

Interventions

• Social Engage (S-ENGAGE)
• The Healthy Lifestyles Education Program

Trial Overview The study tests a program called SOCIAL-ENGAGE designed to increase cultural-social engagement and reduce suicide risk among Spanish-speaking adults at risk for suicide. It involves optimizing the intervention with a small group first, then testing its effectiveness in a larger pilot randomized controlled trial (RCT).

Participant Groups

Group I: Social Engage (S-ENGAGE) Experimental Treatment 1 Intervention

S-ENGAGE is a skills-based psychotherapy that focuses on helping patients engage in meaningful rewarding social activities. Subjects will receive 10 one-hour individual sessions of S-ENGAGE over 10 weeks.

Group II: The Healthy Lifestyles Education Program Placebo Group 1 Intervention

The healthy lifestyles education program consists of a notebook containing evidence-based educational material on mental health, physical activity, and information on community resources. Study staff meet with participants once, individually, for 1 hour to review each section and answer questions participants might have.

Who Is Running the Clinical Trial?

University of Rochester

Lead Sponsor

Trials

883

Recruited

555,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

A quality improvement project involving 134 veterans hospitalized for suicidal thoughts showed that a new single-session suicide-focused psychoeducation group was highly acceptable and perceived as useful by participants.

After attending the group, veterans reported increased hope and motivation to learn coping skills for their suicidal thoughts, indicating the potential effectiveness of this intervention in an inpatient setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding suicide: Development and pilot evaluation of a single-session inpatient psychoeducation group. Gebhardt, HM., Ammerman, BA., Carter, SP., et al.[2022]

The PEPSUI program, a 10-week psychoeducational intervention for patients who attempted suicide, showed promising results in improving participants' perceptions of mental health services and equipping them with skills for stress management and distress tolerance.

Qualitative feedback indicated that the PEPSUI program led to deeper life changes, such as enhanced mindfulness, improved decision-making, and a greater sense of meaning and control in life, suggesting its potential effectiveness in suicide prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

PEPSUI, a Psychoeducational Program for the Management of Suicidal Patients: A Qualitative Study From a Randomized Controlled Trial. Henrion, A., Courtet, P., Arpon-Brand, V., et al.[2022]

In a study of 418 adults with suicidal thoughts participating in a 6-week online self-help program, those in the intervention group logged in significantly more times (17.3 logins) compared to the control group (9.7 logins), indicating higher engagement with the program.

Engagement was notably higher among individuals with more severe suicidal thoughts, suggesting that tailored strategies based on sociodemographic and clinical characteristics could enhance participation and effectiveness of online mental health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors associated with engagement in online self-help programs among people with suicidal thoughts. Batterham, PJ., Han, J., Mackinnon, AJ., et al.[2021]

A scoping review of systematic reviews found that multimodal suicide prevention programs, particularly those using psychoeducation and gatekeeper strategies, are effective in improving knowledge about suicide and reducing suicide rates among university students.

Gatekeeper interventions, especially when delivered to peer counselors, showed the highest effectiveness in enhancing knowledge and self-efficacy in suicide prevention, although they require more resources and time for implementation and evaluation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness. Cecchin, HFG., Murta, SG., de Macedo, EOS., et al.[2022]

A systematic review of 185 clinical trials involving 22,656 records found that social support interventions significantly reduced the number of suicides, with a risk ratio of 0.48, indicating nearly a 52% reduction in suicide risk among participants receiving support.

However, the same interventions did not show a significant effect on reducing suicide attempts, with a pooled risk ratio of 0.88, suggesting that while social support can help prevent suicides, it may not be as effective in preventing suicide attempts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Methods and efficacy of social support interventions in preventing suicide: a systematic review and meta-analysis. Hou, X., Wang, J., Guo, J., et al.[2022]

The SAFETY-A intervention significantly improved treatment linkage rates for racial-ethnic minority youths after emergency department treatment for suicidal episodes, compared to those receiving enhanced usual care.

This study involved 105 participants and suggests that SAFETY-A is an effective approach to promote mental health equity and continuity of care for at-risk youths.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A. Kodish, T., Lau, AS., Belin, TR., et al.[2023]

A gatekeeper suicide-prevention program was successfully implemented in a local school system, targeting faculty and staff who regularly interact with middle- and high-school students, leading to increased knowledge about adolescent suicide prevention.

Participants showed significant improvement in understanding risk factors, appropriate responses to suicidal students, and available community resources, emphasizing the need for ongoing education and training in schools to support suicide prevention efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adolescent suicide prevention in a school setting: use of a gatekeeper program. Johnson, LA., Parsons, ME.[2022]

The 'SOS output education' program for junior high school students, involving community cooperation, effectively increased awareness of support-seeking behaviors among participants, as evidenced by a rise in the number of students expressing worries after the program.

Three months post-program, there was a significant increase in the number of students identifying 'reliable adults' and 'adults to talk to at any time,' indicating enhanced social support networks, which may contribute to reducing lifelong suicide risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide Prevention Program with Cooperation from Senior Volunteers, Governments, and Schools: A Study of the Intervention Effects of "Educational Lessons Regarding SOS Output" Focusing on Junior High School Students. Ogawa, S., Suzuki, H., Takahashi, T., et al.[2022]

The Surviving the Teens® program significantly reduced suicidal thoughts and behaviors among high school students, with a notable decrease in those considering suicide or making plans over a 3-month follow-up period after the program.

Students reported increased self-efficacy in seeking help and a greater likelihood of knowing supportive adults in school, indicating the program's effectiveness in fostering a supportive environment for mental health discussions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary effectiveness of surviving the teens(®) suicide prevention and depression awareness program on adolescents' suicidality and self-efficacy in performing help-seeking behaviors. King, KA., Strunk, CM., Sorter, MT.[2022]

Long-term community education programs that engage society at multiple levels and establish support networks are more effective in reducing suicide rates, according to a review of 48 studies.

Most interventions have succeeded in changing public attitudes and knowledge about suicide, but these changes often do not translate into actionable outcomes, especially in short-duration programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide prevention programs through community intervention. Fountoulakis, KN., Gonda, X., Rihmer, Z.[2022]

References

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

Understanding suicide: Development and pilot evaluation of a single-session inpatient psychoeducation group. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

PEPSUI, a Psychoeducational Program for the Management of Suicidal Patients: A Qualitative Study From a Randomized Controlled Trial. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Factors associated with engagement in online self-help programs among people with suicidal thoughts. [2021]

4. Brazil pubmed.ncbi.nlm.nih.gov

Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Methods and efficacy of social support interventions in preventing suicide: a systematic review and meta-analysis. [2022]

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

Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A. [2023]

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

Adolescent suicide prevention in a school setting: use of a gatekeeper program. [2022]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Suicide Prevention Program with Cooperation from Senior Volunteers, Governments, and Schools: A Study of the Intervention Effects of "Educational Lessons Regarding SOS Output" Focusing on Junior High School Students. [2022]

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

Preliminary effectiveness of surviving the teens(®) suicide prevention and depression awareness program on adolescents' suicidality and self-efficacy in performing help-seeking behaviors. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Suicide prevention programs through community intervention. [2022]