92 Participants Needed

PEACE App Intervention for Suicide Prevention in Veterans

(VA-BIC RCT Trial)

KR
NR
Overseen ByNatalie Riblet, MD MPH
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: VA Office of Research and Development
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

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

The trial information does not specify whether you need to stop taking your current medications. It seems focused on using a mobile app and a manual-based intervention to support mental health care.

What data supports the effectiveness of the PEACE App Intervention for Suicide Prevention in Veterans?

Research shows that mobile apps can help manage suicide risk by tracking mood, creating safety plans, and providing access to support networks. Additionally, the REACH VET program successfully identified and connected veterans at risk of suicide with care, suggesting that similar app-based interventions could be effective.12345

How is the PEACE App Intervention treatment for suicide prevention in veterans different from other treatments?

The PEACE App Intervention is unique because it combines VA-BIC (Veterans Affairs Brief Intervention and Contact) with a mobile mental health app, focusing on education, awareness, connection, and engagement to prevent suicide, which is different from traditional treatments that may not integrate technology or emphasize these specific components.56789

What is the purpose of this trial?

The VA is committed to reducing suicide in the U.S. Veteran population. Over 6,000 Veterans die from suicide each year, and this risk is particularly high following a psychiatric hospitalization. This may be due to problems with engagement in care and poor social connectedness. Although the VA has implemented tools to address Veteran suicide risk, suicide after psychiatric discharge remains an ongoing problem. This has highlighted the need to develop new interventions and approaches to post-discharge mental health care within the VA. In response, this project is a randomized control trial of an intervention an intervention called Prevention of suicide: Education, Awareness, Connection, and Engagement (PEACE). This intervention is comprised of two synergistic and promising components to prevent suicide: 1) a mobile mental health app, which aims to improve social connectedness after discharge; and 2) a manual-based intervention called the Veterans Affairs Brief Intervention and Contact Program (VA-BIC), which promotes engagement in care. The overall goal of this study is to determine if the PEACE intervention combined with standard discharge care reduces suicidal ideation as compared to a control group receiving only standard discharge care.

Research Team

NR

Natalie Riblet, MD MPH

Principal Investigator

White River Junction VA Medical Center, White River Junction, VT

Eligibility Criteria

This trial is for U.S. Veterans eligible for VA services who were hospitalized due to acute self-harm risk, can speak English, and are willing to use a smartphone app. It excludes those unable to consent or considered vulnerable such as prisoners or involuntarily committed patients.

Inclusion Criteria

I can use a smartphone and am willing to download an app.
Be a Veteran eligible to receive VA services;
Per the unit psychiatrist, hospitalization was due to concerns about acute risk for self-harm including suicidal ideation, suicide attempt, and/or admitting provider deemed the patient was at imminent risk for self-harm;

Exclusion Criteria

The investigators do not plan to enroll any potentially vulnerable populations including prisoners, or involuntarily committed patients.
Unable to provide informed consent;

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the PEACE intervention, which includes a mobile mental health app and the VA-BIC program, or standard discharge care

6 months
8 contacts (in-person or virtual) for PEACE group

Follow-up

Participants are monitored for suicidal ideation, social connectedness, and engagement in care at one, three, and six months post-discharge

6 months
3 visits (in-person or virtual)

Treatment Details

Interventions

  • PEACE
Trial Overview The study tests the PEACE intervention, which includes a mental health app and the VA-BIC program aimed at improving social connections and care engagement post-discharge, against standard psychiatric discharge care in preventing suicide.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: PEACEExperimental Treatment2 Interventions
The PEACE intervention will be delivered by a trained mental health staff member, such as a study psychologist, mental health nurse, social worker, or psychiatrist. The intervention consists of three synergistic components that work to support the patient after inpatient psychiatric discharge: 1) Brief educational component, where the patient receives a one-hour, one-on-one, personalized educational session on suicide prevention; 2) Seven regular contacts after discharge, where the study psychologist who delivered the brief educational visit will contact the patient to monitor the patient's symptoms, assess treatment adherence, review their safety plan, and assist the patient with engaging in care, if needed; and 3) Mobile app, which aims to improve the patient's social connectedness and provide additional educational materials on suicide. Patients in this arm will also continue to receive standard post-discharge psychiatric care.
Group II: ControlExperimental Treatment1 Intervention
Those randomized to the control arm will receive standard psychiatric hospital discharge care alone. Current VA standard discharge care includes five core elements. First, patients and their outpatient providers are required to be involved in discharge planning. Second, patients should be offered evidence-based treatments to address their mental health symptoms. Third, the inpatient team should work with the patient to complete a safety plan prior to discharge. Fourth, the inpatient team should arrange two follow-up care visits within 30 days of discharge. Fifth, the inpatient team in conjunction with the SPC assess whether patients are appropriate to be placed on the High Risk for Suicide List. Patients who are placed on the High Risk for Suicide List receive enhanced oversight as outlined in VA policy.

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

White River Junction Veterans Affairs Medical Center

Collaborator

Trials
32
Recruited
17,900+

Findings from Research

Out of 69 assessed depression and suicide prevention apps, only 5 (7%) included all six recommended suicide prevention strategies, highlighting a significant gap in adherence to evidence-based guidelines.
Several popular apps provided incorrect crisis helpline numbers, raising concerns about the safety and reliability of mental health resources available to users, particularly given that some apps had over a million downloads.
Suicide prevention and depression apps' suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines.Martinengo, L., Van Galen, L., Lum, E., et al.[2022]
In a study of 129 participants, the app-assisted treatment (TAU+APP) showed a smaller decrease in self-reported suicide risk compared to standard treatment alone (TAU), indicating a medium effect size, which raises concerns about the integration of technology in therapy.
No significant differences were found in depressive symptoms between the two groups, suggesting that while the app may not enhance depression treatment, it could complicate suicide risk management, highlighting the need for careful consideration of how technology is used in psychological interventions.
Testing an App-Assisted Treatment for Suicide Prevention in a Randomized Controlled Trial: Effects on Suicide Risk and Depression.O'Toole, MS., Arendt, MB., Pedersen, CM.[2022]
The REACH VET program, developed by the U.S. Veterans Health Administration, successfully identified and connected 98% of 6,579 veterans at risk of suicide with appropriate care by October 2020, demonstrating its efficacy in suicide prevention.
The implementation of this program in the largest U.S. healthcare system shows that using a statistical model for suicide prediction can be effectively integrated into clinical practice to enhance patient care.
The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice.Matarazzo, BB., Eagan, A., Landes, SJ., et al.[2023]

References

Suicide prevention and depression apps' suicide risk assessment and management: a systematic assessment of adherence to clinical guidelines. [2022]
Testing an App-Assisted Treatment for Suicide Prevention in a Randomized Controlled Trial: Effects on Suicide Risk and Depression. [2022]
The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice. [2023]
The feasibility of using smartphone apps as treatment components for depressed suicidal outpatients. [2023]
Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care. [2015]
Suicidal Thoughts and Behaviors in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study. [2023]
A national examination of suicidal ideation, planning, and attempts among United States adults: Differences by military veteran status, 2008-2019. [2023]
Suicidality among older male veterans in the United States: results from the National Health and Resilience in Veterans Study. [2013]
Brief assessment for suicidal ideation in OEF/OIF veterans with positive depression screens. [2022]
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Back to top
Terms of Service·Privacy Policy·Cookies·Security