Public Messaging for Suicide Prevention in Veterans

Recruiting at 1 trial location

Overseen By Elizabeth Karras-Pilato, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Mental health treatment, Impaired, Institutionalized

Compensation: Varies

Number of Visits: 2

420 Participants Needed

Trial Summary

What is the purpose of this trial?

The risk for suicide increases by nearly 50% in the first year that service members transition from the military to civilian life underscoring the need for effective strategies to facilitate help seeking among Veterans vulnerable to self-directed violence. Yet despite a great need for treatment, more than half of returning Veterans at risk for suicide do not initiate mental health services. VA has embarked on the regular use of communication campaigns as part of a public health approach designed to reach the larger Veteran population with messages promoting help seeking. However, what types of messages effectively change beliefs and behaviors for at-risk Veterans resistant to seek treatment is unclear. The main objective of this study is to develop and test the use of public messaging to increase treatment seeking among Veterans at risk for suicide and resistant to seek mental health care following separation from military service. This represents the first study to systematically develop public messaging strategies for populations 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.

What data supports the effectiveness of the treatment Messaging, Public Messaging, Communication Campaigns for suicide prevention in veterans?

Research suggests that public service announcement (PSA) campaigns can increase awareness and encourage help-seeking behaviors, which are important for suicide prevention. However, there is limited direct evidence on the effectiveness of these campaigns specifically for veterans, indicating a need for more targeted studies. ^{1 2 3 4 5}

Is public messaging for suicide prevention in veterans safe?

The research does not provide specific safety data for public messaging in suicide prevention among veterans, but it emphasizes the need for strategic and science-based messaging to support prevention efforts. ^{1 2 3 4 6}

How is the treatment 'Public Messaging for Suicide Prevention in Veterans' different from other treatments for suicide prevention?

This treatment is unique because it uses strategic communication campaigns to promote suicide prevention and mental health among veterans, focusing on creating effective messages that resonate with this specific group, unlike traditional treatments that may involve medication or therapy sessions. ^{1 2 3 6 7}

Research Team

Elizabeth Karras-Pilato, PhD

Principal Investigator

VA Finger Lakes Healthcare System, Canandaigua, NY

Eligibility Criteria

This trial is for U.S. Veterans over 18 who've left the military in the last year, are experiencing suicidal thoughts, and have low intent to seek help but can consent to participate. They must own a smartphone and be willing to use a study app. Those currently or recently in mental health treatment or institutionalized cannot join.

Inclusion Criteria

I am willing and able to verbally agree to participate.

I am over 18 years old.

I own a smartphone and am willing to use the study app.

Exclusion Criteria

currently institutionalized

I was found to have impairments during my screening.

currently (or in the past 12 months) in formal mental health treatment services

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Message Exposure

Participants exposed to 4 study videos over a one-month period and complete telephone-based assessments

4 weeks

Assessments at baseline, 1-month, and 2-month follow-up

Follow-up

Participants are monitored for changes in treatment initiation and beliefs about mental health

2 months

Telephone-based assessments at 1-month and 2-month follow-up

Wait List Control

Participants receive weekly push notifications while wait-listed

2 months

Treatment Details

Interventions

• Messaging
• Wait list control

Trial Overview The study aims to develop and test public messaging strategies designed to encourage Veterans at risk of suicide and resistant to seeking mental health care after leaving the military service, comparing message effectiveness with a wait list control group.

Participant Groups

Group I: Message Exposure Experimental Treatment 1 Intervention

Participants exposed to 4 study videos over a one-month period and complete telephone-based assessments at baseline, 1- and 2-month follow up. Study videos are delivered by study's mobile app downloaded to participants' own Smartphone.

Group II: Wait List Control Placebo Group 1 Intervention

While wait-listed, participants will receive one push notification each week thanking them for participation, informing them that they will receive messages in the near future or reminding them of the length of the study. Telephone-based assessments are completed at baseline, 1- and 2-month follow up. Push notifications are delivered by study's mobile app downloaded to participants' own Smartphone.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

There is a critical need for strategic and science-based messaging to effectively address suicide prevention in US military and veteran populations, as current communications often do not align with prevention goals.

Research highlights the importance of developing consistent and supportive messaging that can enhance suicide prevention efforts, although specific studies on the effectiveness of these communications are currently limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using science to improve communications about suicide among military and veteran populations: looking for a few good messages. Langford, L., Litts, D., Pearson, JL.[2022]

A study involving 33 US veterans identified key reasons why suicide prevention messages may not resonate, including issues with language, imagery, and the credibility of the messenger.

The findings highlight the need for tailored communication strategies to effectively engage veterans in suicide prevention efforts, although the results are limited to a specific group and may not be broadly applicable.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Exploration of Barriers to Suicide Prevention Messaging With US Veterans. Karras, E., Levandowski, BA., McCarten, JM.[2022]

The pilot evaluation of the It's Your Call campaign showed that mixed messaging strategies significantly increased the use of the Veterans Crisis Line among US military veterans, indicating effective communication can promote help-seeking behaviors.

The study, which analyzed daily call data from 10 cities during 2011-2012, suggests that mixed messages are more effective than other strategies in encouraging veterans to reach out for support, highlighting the importance of tailored messaging in suicide prevention efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting Help Seeking to Veterans. Karras, E., Lu, N., Elder, H., et al.[2018]

Veterans at risk for suicide responded positively to messages with solemn themes and provocative imagery, indicating that emotionally intense content may be more effective in engaging this population.

Despite recognizing the importance of help-seeking messages, participants felt that actionable steps, like using crisis lines, were not clearly communicated, which could hinder their effectiveness in promoting help-seeking behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of Public Messaging to Facilitate Help Seeking during Crisis among U.S. Veterans at Risk for Suicide. Karras, E., Arriola, N., McCarten, JM., et al.[2022]

This study suggests that short-term exposure (1 month) to suicide prevention public service announcements (PSAs) can increase help-seeking behaviors among individuals at risk and those concerned about them.

While the results indicate that PSAs may effectively promote help-seeking, the study faced methodological limitations that prevented a clear comparison of the effectiveness between PSAs and printed flyers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Effectiveness in Initiating Help-Seeking Behaviors by Exposure to an Adult Male Public Service Announcement. Reidenberg, D., Berman, A.[2022]

A study involving 809 U.S. veterans aged 44 to 65 identified that perceived behavioral control is a major predictor of their intentions to seek help for suicidal behaviors and mental health issues.

The research highlights the importance of understanding veterans' attitudes and social norms when designing effective suicide prevention messaging, suggesting that tailored communication strategies could enhance help-seeking behaviors in this high-risk group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Use of Theory-Based Formative Research to Design Suicide Prevention Messaging for U.S. Veterans in Midlife. Karras, E., Stokes, CM., Warfield, SC., et al.[2022]

A study involving 2526 telephone surveys suggests that media campaigns can effectively promote suicide prevention hotlines specifically to Veteran households.

The findings indicate a need for more research to explore how media campaigns can enhance suicide prevention efforts for Veterans, highlighting their potential value in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using media to promote suicide prevention hotlines to Veteran households. Karras, E., Stephens, B., Kemp, JE., et al.[2022]

References

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

Using science to improve communications about suicide among military and veteran populations: looking for a few good messages. [2022]

2. Canada pubmed.ncbi.nlm.nih.gov

An Exploration of Barriers to Suicide Prevention Messaging With US Veterans. [2022]

3. Canada pubmed.ncbi.nlm.nih.gov

Promoting Help Seeking to Veterans. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Perceptions of Public Messaging to Facilitate Help Seeking during Crisis among U.S. Veterans at Risk for Suicide. [2022]

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

Evaluating the Effectiveness in Initiating Help-Seeking Behaviors by Exposure to an Adult Male Public Service Announcement. [2022]

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

The Use of Theory-Based Formative Research to Design Suicide Prevention Messaging for U.S. Veterans in Midlife. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Using media to promote suicide prevention hotlines to Veteran households. [2022]