Suicide Risk Model for Suicide Prevention

Enrolling by invitation at 2 trial locations

Overseen By Bobbi Jo H Yarborough, PsyD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Kaiser Permanente

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if the Suicide Attempt Risk Model Care Pathway can reduce suicide attempts among individuals receiving behavioral health care. Researchers will compare two groups: one using this new model and another receiving standard care. The trial is open to anyone over 18 who has visited a participating behavioral health clinic. As an unphased trial, it offers participants the chance to contribute to groundbreaking research that could enhance future behavioral health care.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this suicide risk model is safe for patients receiving behavioral health care treatment?

Research has shown that using a suicide risk model in healthcare is generally safe for patients. One study found that the Zero Suicide model, similar to the Suicide Attempt Risk Model Care Pathway, led to fewer suicide attempts in three out of four major health systems. This suggests the model effectively reduces suicide attempts and is well-received.

Reports of major negative effects from using these models have not emerged. The primary goal is to improve care and better identify risks, making it a promising tool for preventing suicide. Overall, evidence supports the safety of using risk models in mental health care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Suicide Attempt Risk Model Care Pathway because it offers a new way to predict and prevent suicide attempts more effectively than traditional methods. Unlike the usual care pathways that typically rely on patient self-reporting and clinician judgment, this model uses advanced algorithms to identify individuals at high risk based on various data inputs. By implementing this predictive technology, the model aims to provide timely interventions that could potentially save lives and reduce the incidence of suicide attempts.

What evidence suggests that the Suicide Attempt Risk Model Care Pathway is effective for reducing suicide attempts?

Research shows that a suicide risk model can help reduce suicide attempts. In this trial, participants in the intervention arm will receive care through the implementation of this model. One study found that using the model during mental health visits screened many patients for suicide risk, identifying those at risk and providing specific support. Another study found that applying this model in primary care settings led to fewer suicide attempts and deaths. These findings suggest that a structured suicide risk model can improve outcomes for people receiving mental health care. ^{1 2 3 6 7}

Who Is on the Research Team?

Bobbi Jo Yarborough, PsyD

Principal Investigator

Kaiser Permanente

Are You a Good Fit for This Trial?

This trial is for adults over the age of 18 who have visited a behavioral health clinic at one of the participating sites. There are no specific exclusion criteria, meaning it's open to anyone meeting the inclusion conditions.

Inclusion Criteria

You have made at least one visit to a behavioral health facility affiliated with the program.

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Implementation of the suicide risk model in behavioral health clinics

18 months

Ongoing visits as per usual care schedule

Follow-up

Participants are monitored for suicide attempts and other outcomes post-index encounter

90 days

Regular follow-up visits

Long-term follow-up

Monitoring of secondary outcomes such as identification and recognition through study completion

18 months

What Are the Treatments Tested in This Trial?

Interventions

• Suicide Attempt Risk Model Care Pathway

Trial Overview

The study is testing whether a suicide risk model can help reduce suicide attempts when implemented in patients receiving behavioral health care. It compares outcomes between those identified by this model and those receiving usual care without the model.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Implementation of the suicide risk model

Group II: Usual Care Active Control 1 Intervention

Usual care suicide prevention pathway

Who Is Running the Clinical Trial?

Kaiser Permanente

Lead Sponsor

Trials

563

Recruited

27,400,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Henry Ford Health System

Collaborator

Trials

334

Recruited

2,197,000+

HealthPartners Institute

Collaborator

Trials

196

Recruited

3,721,000+

Published Research Related to This Trial

In the ED-SAFE study, structured telephone follow-up assessments were crucial for identifying adverse events (AEs), detecting 45% of total AEs that were missed by chart reviews alone.

The detection of suicide attempts varied significantly by method, with structured follow-ups identifying 59% of attempts compared to only 18% through chart reviews, highlighting the importance of using multiple detection methods in suicide research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using structured telephone follow-up assessments to improve suicide-related adverse event detection. Arias, SA., Zhang, Z., Hillerns, C., et al.[2021]

A qualitative study involving experienced suicide researchers revealed significant challenges in defining and reporting adverse events (AEs) and serious adverse events (SAEs) in suicide prevention trials, which complicates safety evaluations.

Participants emphasized the urgent need for clear and consistent definitions and reporting standards for AEs and SAEs to improve the comparability of studies and enhance safety monitoring in at-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variability in the definition and reporting of adverse events in suicide prevention trials: an examination of the issues and a proposed solution. Oquendo, MA., Feldman, S., Silverman, E., et al.[2022]

The study analyzed responses from 49 patients regarding helpful aspects of their treatment for suicidal risk, leading to the development of a reliable coding system to identify major themes in their experiences.

Insights gained from 52 patients on what they learned from their clinical care can inform future suicide-specific treatments, highlighting the importance of patient feedback in improving therapeutic approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Successful Treatment of Suicidal Risk. Schembari, BC., Jobes, DA., Horgan, RJ.[2022]

Suicide is a major public health crisis, with over 44,000 deaths in the US alone in 2015, highlighting the urgent need for effective suicide prevention strategies that integrate research into practice.

The article introduces the Assess, Intervene and Monitor for Suicide Prevention (AIM-SP) model, which provides a structured approach to implementing evidence-based practices in clinical settings, focusing on ongoing risk assessment and support for individuals at high risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care. Brodsky, BS., Spruch-Feiner, A., Stanley, B.[2023]

The Safety Planning Intervention (SPI) is effective in reducing suicidal ideation and behavior, as well as improving depression and treatment engagement among adults experiencing suicide-related distress, based on a systematic review of 26 studies.

The SPI is adaptable and can be delivered in various formats (in-person or online) and as a standalone or combined intervention, making it a flexible tool in suicide prevention practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of the Safety Planning Intervention for Adults Experiencing Suicide-Related Distress: A Systematic Review. Ferguson, M., Rhodes, K., Loughhead, M., et al.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11976489/

Zero Suicide Model Implementation and Suicide Attempt ...

Among 4 674 515 eligible mental health visits in 2019, 3 416 904 visits (73%) included a suicide risk screening. Of 128 996 individuals who ...

2.

henryford.com

henryford.com/-/media/files/henry-ford/campaigns/miminds/publications/effectiveness-of-integrating-suicide-care-in-primary-care.pdf

Effectiveness of Integrating Suicide Care in Primary Care

in suicide attempts and deaths after the implementation of a systematic SC pathway, including suicide risk screening, assessment, brief ...

3.

clinicaltrials.gov

clinicaltrials.gov/study/NCT06060535

Implementation of Suicide Risk Models in Health Systems

... effectiveness of the suicide prevention care models ... suicide risk model. Intervention/Treatment, Behavioral : Suicide Attempt Risk Model Care Pathway.

4.

zerosuicide.edc.org

zerosuicide.edc.org/evidence/evidence-base

Evidence Base | Zero Suicide - edc.org

Zero Suicide is based on the best research to date for suicide prevention in health care. Behind each of the seven elements of Zero Suicide are evidence-based ...

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12005173/

Effectiveness of Integrating Suicide Care in Primary Care

Integration of suicide care (SC) practices in mental health specialty settings has shown positive outcomes. A large public mental health service ...

6.

bmcpsychiatry.biomedcentral.com

bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06760-0

Study protocol for a stepped-wedge, randomized controlled ...

This trial will determine whether the use of such a risk model reduces suicide attempts compared to usual care. By describing important ...

7.

research.kpchr.org

research.kpchr.org/News/CHR-Stories/Health-System-Approach-Prevents-Suicide-Attempts

Health System Approach Prevents Suicide Attempts

Published in JAMA Network Open, their study found that the ZS model significantly reduced suicide attempts in three of four major health systems ...