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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a new program, Social Engage (S-ENGAGE), can help Spanish-speaking Hispanic adults with suicidal thoughts become more socially and culturally active, potentially reducing their suicide risk. Participants will either attend ten sessions of S-ENGAGE, which focuses on engaging in meaningful social activities, or receive educational material on healthy lifestyles through The Healthy Lifestyles Education Program. The study seeks Spanish-speaking Hispanic adults who are part of the UR health system, have low social engagement, and have experienced recent suicidal thoughts. As an unphased trial, this study offers participants the chance to contribute to important research that could lead to new methods of reducing suicide risk.

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 prior data suggests that the SOCIAL ENGAGE (S-ENGAGE) program is safe for Spanish-speaking adults at risk for suicide?

Research has shown that Social Engage (S-ENGAGE) is a promising method for reducing suicidal thoughts by fostering social connections. A small initial study found this method effective and well-received by participants. Those in the study reported feeling more connected and less alone, which are crucial factors in lowering suicide risk.

Social Engage is a therapy that teaches skills for participating in meaningful social activities. Early results suggest this approach is safe, with no major side effects reported. The emphasis on social support and connection is a key reason for its safety and effectiveness.

In summary, current evidence suggests that Social Engage is a well-tolerated and potentially effective treatment for individuals at risk of suicide, with safety data showing no major concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about S-ENGAGE because it takes a fresh approach to tackling suicidal thoughts by focusing on social engagement. Unlike traditional treatments that might center on medication or general talk therapy, S-ENGAGE is a skills-based psychotherapy. It specifically helps patients find and participate in meaningful and rewarding social activities, which can provide a sense of purpose and connection. This focus on social engagement as a therapeutic tool offers a unique way to address mental health challenges, potentially leading to more lasting improvements in well-being.

What evidence suggests that this trial's treatments could be effective for reducing suicide risk among Spanish-speaking adults?

Research has shown that social support can greatly lower the risk of suicide. One study found that participation in social support activities nearly halved the number of suicides. Feeling connected and supported through social interactions is crucial in preventing suicide. In this trial, participants may receive the Social Engage (S-ENGAGE) program, which focuses on creating positive social connections to help protect against suicidal thoughts. This approach encourages participation in enjoyable social activities, which can reduce the risk of suicide by strengthening social networks and support systems. ^{1 4 6 7 8}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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).

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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 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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8788249/

Methods and efficacy of social support interventions in ... The number of suicides was significantly reduced in the intervention group (risk ratio (RR)=0.48, 95% CI 0.27 to 0.85). In 14 studies with a ...

2. zerosuicide.edc.org zerosuicide.edc.org/toolkit/evidence-base/engage

Engage | Zero Suicide - edc.org Patients at risk for suicide agree to actively engage in a package of evidence-based practices that directly targets their suicidal thoughts and behaviors.

3. sciencedirect.com sciencedirect.com/science/article/pii/S0213616324000168

The role of communication and social support in suicidal ... Social support and quality communication are crucial in suicide prevention. This systematic review aimed to identify and summarize the research.

4. sprc.org sprc.org/effective-prevention/a-comprehensive-approach-to-suicide-prevention/promote-social-connectedness-and-support/

Promote Social Connectedness and Support Social support and connection are key protective factors against suicide. Positive and supportive social relationships and community connections can help buffer ...

5. hhs.gov hhs.gov/sites/default/files/national-strategy-suicide-prevention.pdf

2024 National Strategy for Suicide Prevention Suicide rates increased by 12.7% from 2012 to 2022, with brief declines in. 2019 and 2020. Existing gaps in social and economic risk factors ( ...

6. cdc.gov cdc.gov/suicide/disparities/index.html

Health Disparities in Suicide | Suicide Prevention Some populations experience more negative social conditions and have higher rates of suicide or suicide attempts than the general US population.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10189833/

Effectiveness of Suicide Safety Planning Interventions Evidence across a range of studies indicates that SSP is effective for reducing suicide behavior (SB) and ideation (SI).

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8286301/

A Pilot Randomized Trial of Engage Psychotherapy to ... We conducted a pilot RCT to examine acceptability, feasibility, and efficacy of Social Engage Psychotherapy (S-ENG) to improve social disconnection and reduce ...