Family and Social Justice Service for Suicide and Self-Harm

Overseen By Taylor Witkowski

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Cambridge Health Alliance

Disqualifiers: Under 18, No police involvement, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

1040 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to reduce suicide rates by improving collaboration among systems like health and legal services. It focuses on individuals who have cycled in and out of jail and require mental health support. Participants will be divided into three treatment paths, including one that pairs them with a navigator to help coordinate care as part of the Family and Social Justice Service and Navigator (FSJS+Navigator) Intervention. Ideal candidates for this trial are those from the Cambridge area who have interacted with police and need emergency mental health care. As an unphased trial, this study offers a unique opportunity to contribute to innovative solutions for mental health care coordination.

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's best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that the Family and Social Justice Service and Navigator (FSJS+Navigator) Intervention is safe?

Research shows that the Family and Social Justice Service and Navigator (FSJS+Navigator) Intervention supports individuals at risk of suicide after leaving jail. This program employs a Systems Navigator in the Emergency Department, a community health worker with personal experience related to participants' challenges. The goal is to improve care coordination and ensure continuous support.

For the Family and Social Justice Section (FSJS) intervention, studies of similar support systems suggest they can help reduce the risk of suicide, indicating that the FSJS intervention might also be safe and helpful.

Both programs aim to provide structured support to individuals involved with the criminal justice system. Although specific safety data for these programs is not detailed, their design suggests they are generally well-tolerated and could help prevent suicide and self-harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Family and Social Justice Service and Navigator (FSJS+Navigator) intervention because it offers a holistic approach to addressing suicide and self-harm. Unlike traditional treatments that might focus solely on medication or therapy, this intervention integrates social justice and family support to tackle root causes and provide comprehensive care. By involving community resources and personalized navigation, this approach aims to enhance support networks and improve mental health outcomes for individuals in crisis. This innovative strategy could lead to more sustainable and effective solutions compared to standard treatment options.

What evidence suggests that this trial's treatments could be effective for suicide prevention?

Research has shown that the Family and Social Justice Service and Navigator (FSJS+Navigator) program, one of the interventions in this trial, might help lower the risk of suicide for people involved with the criminal justice system. Studies have found that similar programs improve mental health by connecting people to needed services after emergency room visits. These programs often lead to more follow-up care, which is crucial for mental health support. Research suggests that another intervention in this trial, the Family and Social Justice Service (FSJS) program, reduces suicide risks through community and family support. This approach focuses on building protective factors and improving access to mental health resources, both of which are vital in preventing self-harm. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals aged 18-100 who have interacted with the criminal justice system and are patients of Cambridge Health Alliance from specific areas. They must have had police contact between 2009 and 2019 but cannot be currently incarcerated. The study aims to help those at risk of suicide by coordinating care as they move in and out of jail.

Inclusion Criteria

I was recruited for the study while in the CHA Emergency Department.

I am a CHA patient living in Everett, Chelsea, Somerville, Medford, Malden, or Winthrop.

I have interacted with the Cambridge Police between 2009 and 2019.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive interventions aimed at suicide prevention and coordination of care across health and criminal justice systems

12 months

Regular interactions with health and criminal justice systems

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Family and Social Justice Service and Navigator (FSJS+Navigator) Intervention

Trial Overview The study tests how well different support systems work for people at risk of suicide after jail release. It compares usual treatment, a Family and Social Justice approach, and that approach plus a Navigator service to coordinate healthcare across systems.

How Is the Trial Designed?

Group I: Treatment as usual (TAU) Experimental Treatment 1 Intervention

This arm will consist of 2160 eligible individuals identified to have had criminal legal involvement in Cambridge Health Alliance catchment area cities other than Cambridge (Everett, Somerville, Malden, Medford, Chelsea, Revere, Winthrop). Police departments in these Treatment as Usual cities have no programs that link police officers and clinicians to follow up on safety planning and services. These individuals will be identified as having police involvement between 2009 and 2019.

Group II: Family and Social Justice Section (FSJS) Experimental Treatment 1 Intervention

Consists of 200 Cambridge Health Alliance Patients Ages 18-100 Individuals who have come into contact with the Cambridge Police Department (as identified in the Family and Social Justice Section data) between 2009 and 2019.

Group III: FSJS + Navigator Experimental Treatment 1 Intervention

40 patients recruited during the study period in the Cambridge Health Alliance Emergency Department (ED) Ages 18-100 Individuals who are brought into the ED under police supervision (excluding individuals currently incarcerated) involuntarily brought to the ED for psychiatric evaluation because they are considered to be a risk to themselves or others (MA Law 123(12)); or the subject of a police call for service for a mental health issue who are willingly admitted to the ED

Who Is Running the Clinical Trial?

Cambridge Health Alliance

Lead Sponsor

Trials

65

Recruited

22,400+

Michigan State University

Collaborator

Trials

202

Recruited

687,000+

Mount Auburn Hospital

Collaborator

Trials

5

Recruited

26,400+

Citations

1. withpower.com withpower.com/trial/phase-suicide-2025-1f382

Family and Social Justice Service for Suicide and Self-Harm ... (FSJS+Navigator) Intervention will have tolerable side effects & efficacy for patients with SHOX Deficiency Disorder, Suicidal Ideation and Mental Illness. See

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9367214/

FASE-family and social engagement model for prevention ... The research has two aims, to build evidence on the effectiveness of an Attachment-Based Family Therapy and Resource linkage model to prevent ...

3. addictionpolicy.org addictionpolicy.org/post/justice-involved-individuals-with-substance-use-disorder-are-at-a-higher-risk-for-suicide-even-with

Justice-involved Individuals with Substance Use Disorder ... Research shows that individuals with SUDs, mental health disorders, and criminal legal involvement are five times more likely to consider suicide compared to ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12409944/

Suicide prevention following conviction within the criminal ... Effective suicide prevention sits as a core responsibility of justice and health professionals. Therefore, shared responsibilities and ...

5. sprc.org sprc.org/wp-content/uploads/2022/11/FINAL_2021SPIAG_SPStatePlan.pdf

SUICIDE PREVENTION ACROSS THE LIFESPAN To prevent suicide or self-harm, one must address risk factors and increase protective factors, such as family and community support and ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5474088/

Cognitive-Behavioral Family Treatment for Suicide Attempt ... Results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm. This is the second randomized trial ...

7. sprc.org sprc.org/wp-content/uploads/2023/01/Self-harm-and-Suicide-Prevention-Intervention-and-Postvention-Lessons-from-North-America.pdf

Self-harm and Suicide Prevention, Intervention & Postvention In 2011, 4,552 men and 1,493 women killed themselves in the UK, which is 18.1 and 9.6 per 100,000 population respectively.1.

8. samhsa.gov samhsa.gov/mental-health/suicidal-behavior/prevention-initiatives

SAMHSA's Suicide Prevention Initiatives The purpose of this program is to implement the Zero Suicide intervention and prevention model—a comprehensive, multi-setting suicide prevention ...

9. cdc.gov cdc.gov/suicide/pdf/preventionresource.pdf

Suicide Prevention Resource for Action fewer suicide deaths.113 A fourth study indicated that early access to Social Security benefits reduced suicide rates by 7–8% among those turning 62 years ...