Crisis Line Training for Suicide Prevention in National Guard Members

(CONNECT Trial)

Overseen By Amanda Price

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Unable to provide informed consent

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

538 Participants Needed

Trial Summary

What is the purpose of this trial?

National Guard (NG) are affected by suicide at a much higher rate than civilians. The Military and Veterans Crisis Line (MVCL) is not being used as often as we would expect. The purpose of this study is to find out whether a group-based training session will impact awareness and use of the Military and Veterans Crisis Line (MVCL) among members of the National Guard.

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 Crisis Line Facilitation (CLF) for suicide prevention in National Guard Members?

Research on Crisis Line Facilitation (CLF) shows that it can help reduce suicidal behaviors in high-risk Veterans by increasing their comfort and confidence in using crisis lines during emergencies. Although the effect on actual crisis line usage was not significant, the intervention has been shown to prevent suicidal behaviors in similar populations. ^{1 2 3 4 5}

Is Crisis Line Facilitation safe for use in humans?

The available research on Crisis Line Facilitation (CLF) does not report any safety concerns for humans. It has been used in studies with Veterans to encourage the use of crisis lines, and no adverse effects have been noted. ^{1 2 3 4 5}

How is the Crisis Line Facilitation treatment different from other treatments for suicide prevention?

Crisis Line Facilitation (CLF) is unique because it involves a therapist-led session that educates participants about the crisis line, addresses their concerns about using it, and includes a practice call to the line. This approach is designed to increase comfort and confidence in using the crisis line during future crises, which is different from other treatments that may not focus on direct engagement with crisis resources. ^{1 2 4 6 7}

Research Team

Mark Ilgen, PhD

Principal Investigator

University of Michigan

Eligibility Criteria

This trial is for Michigan Army National Guard members who are part of a unit with over 25 people. Participants must be able to understand the study and agree to join it voluntarily, meaning they can provide informed consent.

Inclusion Criteria

Michigan Army National Guard member

Associated with a unit with more than 25 members

Exclusion Criteria

I am unable to understand and give consent for treatment.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants undergo group-based training sessions to increase awareness and use of the Military and Veterans Crisis Line (MVCL)

1-2 weeks

Follow-up

Participants are monitored for utilization of the Military and Veterans Crisis Line (MVCL) via self-report survey items

6 months

Treatment Details

Interventions

• Crisis Line Facilitation (CLF)
• Passive Implementation

Trial Overview The study tests if group training sessions can increase awareness and usage of the Military and Veterans Crisis Line among National Guard members, potentially helping reduce suicide rates within this community.

Participant Groups

Group I: Crisis Line Facilitation (CLF) Experimental Treatment 1 Intervention

Crisis Line Facilitation (CLF) is a promising translational strategy designed to increase Military and Veteran's Crisis Line (MVCL) use among NG members during periods of elevated suicidal risk by addressing individual-level barriers.

Group II: Passive Implementation Active Control 1 Intervention

The PI condition includes an educational resource brochure describing the Military and Veteran's Crisis Line (MVCL), including the phone number for the crisis line, as well as other mental health services available to National Guard members.

Crisis Line Facilitation (CLF) is already approved in United States for the following indications:

Approved in United States as National Suicide Prevention Lifeline for:

• Suicidal crisis intervention
• Mental health support

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Michigan Army National Guard

Collaborator

Trials

1

Recruited

540+

Findings from Research

The Crisis Line Facilitation (CLF) intervention, which includes education about the Veterans Crisis Line (VCL) and practice calls, showed a significant reduction in suicidal behaviors among high-risk Veterans compared to Enhanced Usual Care over a 12-month follow-up period.

Despite the positive impact on suicidal behaviors, the CLF intervention did not significantly increase the utilization of the VCL among participants, indicating that while it may help prevent crises, it does not necessarily encourage Veterans to reach out for help through the VCL.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Encouraging the use of the Veterans Crisis Line among high-risk Veterans: A randomized trial of a Crisis Line Facilitation intervention. Ilgen, MA., Price, AM., Coughlin, LN., et al.[2023]

Crisis Line Facilitation (CLF) is a brief intervention aimed at increasing the use of the Veterans Crisis Line (VCL) among high-risk Veterans, addressing barriers to its use and providing psychoeducational support.

Preliminary results from a study with 301 participants indicate that Veterans who received CLF reported significantly greater comfort and confidence in using the VCL during crises compared to those who did not receive the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing and testing Crisis Line Facilitation (CLF) to encourage help-seeking in adults receiving inpatient treatment for a suicidal crisis. Ilgen, MA., Stewart, HJ., Lhermitte, SL., et al.[2021]

A review of 33 studies on crisis line services found that while these services aim to reduce psychological distress and suicide risk, high-quality evidence demonstrating their effectiveness is lacking, with most studies rated at high risk of bias.

Most studies focused only on immediate outcomes during the crisis, highlighting the need for future research to assess both short-term and long-term impacts on behavioral health treatment engagement and self-directed violence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Crisis Line Services: A Systematic Review. Hoffberg, AS., Stearns-Yoder, KA., Brenner, LA.[2020]

The Lifeline Crisis Chat Network significantly reduced distress among users, with two-thirds of suicidal chatters finding the chat helpful and nearly half reporting decreased suicidal thoughts after the intervention.

This study provides strong evidence for the effectiveness of online crisis interventions, which is especially important as the Lifeline prepares to expand its services with the new 988 nationwide number for mental health crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters' perceptions of effectiveness. Gould, MS., Chowdhury, S., Lake, AM., et al.[2022]

Volunteers at a Norwegian crisis line reported a significant challenge in reconciling their expectations of providing suicide prevention with the reality that many calls were for ongoing support related to loneliness and mental health issues.

The study suggests that training programs for crisis line volunteers should include strategies for addressing the ongoing support needs of callers, ensuring a more uniform response to various concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caught Between Expectations and the Practice Field. Vattø, IE., Lien, L., DeMarinis, V., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Encouraging the use of the Veterans Crisis Line among high-risk Veterans: A randomized trial of a Crisis Line Facilitation intervention. [2023]

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

Developing and testing Crisis Line Facilitation (CLF) to encourage help-seeking in adults receiving inpatient treatment for a suicidal crisis. [2021]

3. Switzerland pubmed.ncbi.nlm.nih.gov

The Effectiveness of Crisis Line Services: A Systematic Review. [2020]

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

National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters' perceptions of effectiveness. [2022]

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

An Open Trial of a Suicide Safety Planning Group Treatment: "Project Life Force". [2023]

6. Canada pubmed.ncbi.nlm.nih.gov

Caught Between Expectations and the Practice Field. [2022]

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

Establishing standards for the assessment of suicide risk among callers to the national suicide prevention lifeline. [2007]