Digital Peer Support for Suicide

(SWEEP Trial)

Overseen By Peter J Franz, Ph.D.

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Albert Einstein College of Medicine

Disqualifiers: Active mania, Active psychosis, Autism, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 2 weeks

46 Participants Needed

Trial Summary

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 Supporting Wellbeing with Everyday Experiences of Peers (SWEEP) for suicide prevention?

Research shows that peer support interventions, like the PAUSE program, can reduce suicidal thoughts and increase hope by providing understanding and social connection. Additionally, the PREVAIL study found that peer support specialists can effectively relate to and support individuals at high risk for suicide, making such interventions feasible and acceptable. ^{1 2 3 4 5}

Is digital peer support for suicide generally safe for humans?

The available research suggests that digital peer support interventions, like smartphone-based safety plans and internet-based safety plans, are generally well-received and considered acceptable by participants. These interventions have shown high participation rates and satisfaction, indicating they are safe for use in humans. ^{1 6 7 8 9}

How is the SWEEP treatment different from other suicide prevention treatments?

The SWEEP treatment is unique because it uses digital peer support, where individuals with similar experiences provide support through online platforms, which can be more accessible and relatable for young people who prefer text-based communication over traditional verbal methods. ^{1 6 7 10 11}

What is the purpose of this trial?

Suicide risk has increased among youth in underserved communities, where access to mental healthcare is limited. To address this need, the investigator team plans to evaluate the preliminary efficacy of a brief, low-cost, culturally responsive digital intervention for ethnically diverse youth at risk for suicide in The Bronx, NY. In collaboration with community stakeholders, suicide recovery narratives, featuring adolescents' experiences related to recovery from suicidal thoughts will be developed. A smartphone ecological momentary assessment app will be used to evaluate whether a curriculum of these narratives provides anti-suicidal benefits to at-risk adolescents.

Research Team

Peter J Franz, Ph.D.

Principal Investigator

Albert Einstein College of Medicine

Eligibility Criteria

This trial is for adolescents in The Bronx, NY who have had suicidal thoughts and major depressive disorder in the past month. Participants must own a smartphone with a data plan to access the digital intervention.

Inclusion Criteria

I own a smartphone with a data plan.

I have been diagnosed with Major Depressive Disorder in the past month.

I have had thoughts of suicide in the past month.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Preliminary Phase

Collection of suicide recovery narratives from Bronx adolescents

2 weeks

Treatment

Participants receive the SWEEP intervention, involving daily engagement with suicide recovery narratives via a smartphone app

2 weeks

Daily app engagement

Follow-up

Participants are monitored for changes in suicidal thoughts and other psychological measures

2 weeks

Treatment Details

Interventions

• Supporting Wellbeing with Everyday Experiences of Peers (SWEEP)

Trial Overview The study tests 'SWEEP', a culturally responsive digital peer support intervention using recovery narratives on an app to help at-risk youth cope with suicidal thoughts.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

This is a single-arm study. All participants will be allocated to the intervention arm, in which they will receive the digital narrative therapy.

Who Is Running the Clinical Trial?

Albert Einstein College of Medicine

Lead Sponsor

Trials

302

Recruited

11,690,000+

American Foundation for Suicide Prevention

Collaborator

Trials

36

Recruited

10,500+

Yeshiva University

Collaborator

Trials

13

Recruited

2,600+

Ilumivu

Collaborator

Trials

1

Recruited

50+

Findings from Research

Peer-delivered suicide prevention services encompass various roles, including gatekeeping and crisis support, and involve peers from similar backgrounds or shared experiences, highlighting the potential for effective community-based interventions.

Despite the promising nature of these peer support interventions, most studies lacked rigorous methodologies, with only three out of 84 being randomized controlled trials, indicating a need for more robust evaluations of their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer-based interventions targeting suicide prevention: A scoping review. Bowersox, NW., Jagusch, J., Garlick, J., et al.[2022]

The PREVAIL peer support intervention, designed for psychiatric inpatients at high risk for suicide, was found to be feasible and acceptable, with participants attending an average of 6.1 sessions over 12 weeks.

Qualitative feedback from participants indicated that peer specialists effectively provided support and fostered discussions about hope and safety, highlighting the potential of peer support in suicide prevention efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and pilot study of a suicide prevention intervention delivered by peer support specialists. Pfeiffer, PN., King, C., Ilgen, M., et al.[2022]

This systematic review identified 10 studies on peer-led support groups for individuals bereaved by suicide, highlighting their potential benefits despite methodological limitations.

The review suggests a need for clearer definitions of 'peer' and more rigorous evaluations of these interventions to better understand their impact and improve future support practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Scoping Review of Peer-Led Support for People Bereaved by Suicide. Higgins, A., Hybholt, L., Meuser, OA., et al.[2022]

The PAUSE program, which utilized peer workers to provide ongoing support after suicide-related emergencies, showed a decrease in suicidal ideation and an increase in hope among 142 participants over a period from August 2017 to January 2020.

Participants found the program effective and acceptable, highlighting the importance of holistic support and social connectedness, although the small sample size and lack of a control group limit the broader applicability of the results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer Intervention following Suicide-Related Emergency Department Presentation: Evaluation of the PAUSE Pilot Program. Gibson, M., Moreau, N., Balzamo, E., et al.[2023]

A telephone-based mutual peer support intervention for individuals with ongoing depressive symptoms was found to be feasible and acceptable, with 59.3% of the 54 participants completing the 12-week program.

Participants who completed the intervention showed a significant reduction in depression symptoms, with an average decrease of 4.2 points on the BDI-II scale, along with improvements in quality of life and psychological health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telephone-based mutual peer support for depression: a pilot study. Travis, J., Roeder, K., Walters, H., et al.[2022]

A consultation exercise involving stakeholders highlighted that digital social prescribing (DSP) could enhance access and monitoring of support for individuals affected by suicide bereavement, addressing the complexities of their needs.

The exercise identified eight key challenges in providing postvention support and established a framework for testing the feasibility of DSP, indicating its potential to contribute to the evidence base for effective interventions in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting Digital Social Prescribing for Suicide Bereavement Support: The Findings of a Consultation Exercise to Explore the Acceptability of Implementing Digital Social Prescribing within an Existing Postvention Service. Galway, K., Forbes, T., Mallon, S., et al.[2022]

Peer support specialists often mention their own experiences with suicidal thoughts briefly, using them as a way to connect, but do not dwell on these details, which may help create a safe space for participants.

The focus of conversations tends to shift from suicide to recovery and coping strategies, suggesting that peer support can effectively guide discussions towards healing rather than solely on the challenges of suicidal ideation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characterizing suicide-related self-disclosure by peer specialists: a qualitative analysis of audio-recorded sessions. Klim, C., Vitous, CA., Keller-Cohen, D., et al.[2023]

An automated, self-guided Internet-based safety plan (IBSP) was developed and evaluated by 150 participants who reported suicidality, showing moderate perceived utility among users.

Participants generally believed the IBSP could be more helpful for others than for themselves, indicating a potential gap in personal recognition of its benefits, and males were less likely to complete the safety plan steps.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceived Utility of the Internet-Based Safety Plan in a Sample of Internet Users Screening Positive for Suicidality. Spangler, DA., Muñoz, RF., Chu, J., et al.[2022]

The pilot phase of the SmartCrisis 2.0 trial demonstrated that a smartphone-based safety plan for patients with recent suicidal behavior is feasible and well-accepted, with a participation rate of 77% and high satisfaction ratings (overall satisfaction score of 9.6 out of 10).

Patients found the safety plan useful (7.4/10) and easy to use (8.9/10), with common coping strategies including walking and exercise, indicating that the app could be a valuable tool in clinical practice for supporting mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. Porras-Segovia, A., De Granda-Beltrán, AM., Gallardo, C., et al.[2023]

Training in suicide prevention significantly improves the quality of intentions and actions taken by individuals to assist someone at risk of suicide, as shown in a national survey of 3002 Australian adults.

Certain demographic groups, such as males, those with lower education levels, and non-English speakers, are less likely to have received suicide prevention training and may need targeted support to improve their ability to help others in distress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quality of assistance provided by members of the Australian public to a person at risk of suicide: associations with training experiences and sociodemographic factors in a national survey. Jorm, AF., Nicholas, A., Pirkis, J., et al.[2020]

A study mapping online suicide support for young people found a variety of accessible resources, but highlighted a significant gap in services specifically tailored for young adults and students in crisis.

Qualitative feedback indicated that young people prefer clear, concise, and immediate text-based communication for seeking help, and while peer support can be valuable, it may also carry risks that need careful management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements. Cohen, R., Rifkin-Zybutz, R., Moran, P., et al.[2023]

References

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

Peer-based interventions targeting suicide prevention: A scoping review. [2022]

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

Development and pilot study of a suicide prevention intervention delivered by peer support specialists. [2022]

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

Scoping Review of Peer-Led Support for People Bereaved by Suicide. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Peer Intervention following Suicide-Related Emergency Department Presentation: Evaluation of the PAUSE Pilot Program. [2023]

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

Telephone-based mutual peer support for depression: a pilot study. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Adapting Digital Social Prescribing for Suicide Bereavement Support: The Findings of a Consultation Exercise to Explore the Acceptability of Implementing Digital Social Prescribing within an Existing Postvention Service. [2022]

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

Characterizing suicide-related self-disclosure by peer specialists: a qualitative analysis of audio-recorded sessions. [2023]

8. Canada pubmed.ncbi.nlm.nih.gov

Perceived Utility of the Internet-Based Safety Plan in a Sample of Internet Users Screening Positive for Suicidality. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Quality of assistance provided by members of the Australian public to a person at risk of suicide: associations with training experiences and sociodemographic factors in a national survey. [2020]

11. England pubmed.ncbi.nlm.nih.gov

Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements. [2023]