Crisis Response Planning for Suicide Prevention

No longer recruiting at 1 trial location

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Disqualifiers: Serious medical, Neurologic, Substance use, others

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

Compensation: Varies

Number of Visits: 1

Duration: 1 hour

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help adolescents with current suicidal thoughts by testing different types of crisis response planning. Participants will be randomly assigned to one of three groups: a virtual crisis response session, an in-person session, or standard crisis risk management. The study will compare the effectiveness and acceptance of these methods in reducing suicidal thoughts and behaviors. Adolescents aged 14-18 with current suicidal intentions may be suitable for this trial. As an unphased trial, this study offers participants the chance to contribute to important research that could enhance crisis response strategies for adolescents.

Do I need to stop my current medications for this trial?

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 doctor.

What prior data suggests that these crisis response planning methods are safe for adolescents with suicidal intent?

Research has shown that both in-person and online crisis response planning (CRP) are safe and effective for managing suicidal thoughts. Studies have found that in-person CRP significantly reduces the likelihood of suicide attempts. Specifically, one study discovered that individuals who received in-person CRP were 76% less likely to attempt suicide compared to those who received standard treatments.

For online CRP, research indicates it is well-received and effective. Both CRP and similar digital tools have successfully reduced suicidal thoughts when used through telehealth services. Whether the session is in-person or online, the safety and effectiveness remain consistent. No reports of serious side effects or negative events have emerged, making both methods promising options for those seeking help. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these innovative crisis response planning methods for suicide prevention because they offer new, accessible ways to support individuals in crisis. Unlike traditional in-person counseling, the virtual crisis response planning and crisis risk counseling can be conducted online, making it easier for people to access help from anywhere. The virtual crisis response planning is unique as it primarily uses text-based interaction, allowing participants to process and document their thoughts and feelings in real-time. This method also empowers individuals by having them actively participate in identifying their warning signs and coping strategies, providing them with a personalized plan they can refer to when needed. These features could lead to more effective and immediate support for those at risk, potentially revolutionizing how crisis interventions are delivered.

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

Research has shown that Crisis Response Planning (CRP) helps reduce suicidal thoughts and actions. In this trial, participants will receive either in-person or virtual CRP. Studies have found that frequent use of CRP is linked to fewer suicidal thoughts and more positive feelings. Specifically, in-person CRP, when included in a prevention program, has greatly lowered suicide rates. Virtual CRP, delivered through telehealth, also reduces suicidal thoughts. Both in-person and virtual CRP offer promising methods to manage crisis situations and lower the risk of suicide. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for adolescents aged 14-18 who are at high risk for suicide and can provide informed consent. They must have a guardian's permission if under 18, endorse current suicidal intent, and be fluent in English. Those with serious medical conditions, substance use disorders, or without smartphone access cannot participate.

Inclusion Criteria

Participant endorses current desires to make a suicide attempt as defined as answering "yes" to item #3 on the Ask Suicide Screening Question (ASQ) tool

Participant's legal guardian is willing and able to give parental permission (if 14-17 years old)

Participant is able to give informed assent or consent (as applicable by age)

Exclusion Criteria

Lack of access to a personal smartphone

I do not have any serious health or neurological conditions that could affect study results.

Presence of current moderate to severe substance use disorder

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Treatment

Participants receive a 1-hour session of either virtual or in-person crisis response planning or standard crisis risk management

1 hour

1 visit (in-person or virtual)

Follow-up

Participants are monitored for changes in mood, behavior, and suicidality through daily assessments

14 days

Daily assessments (virtual)

Post-treatment Assessment

Feasibility and acceptability of the treatment are assessed 14 days post-treatment

14 days

What Are the Treatments Tested in This Trial?

Interventions

• Crisis Risk Counseling
• In-Person Crisis Response Planning
• Virtual Crisis Response Planning

Trial Overview The study compares three interventions: virtual crisis response planning (CRP), in-person CRP, and standard crisis risk counseling. Participants will be randomly assigned to one of these methods to assess feasibility and effectiveness in reducing suicidality over a two-week period through daily assessments.

How Is the Trial Designed?

Group I: Virtual Crisis Response Planning Experimental Treatment 1 Intervention

The virtual crisis response planning (CRP) session will last between 30 minutes to 1-hour and be conducted via doxy.me with a trained study therapist. The virtual CRP is primarily text-based, instead of verbal, and utilizes the chat feature on doxy.me. CRP involves the following standard suicide intervention strategies: supportive listening, provision of crisis resources, and referral to a mental health professional (if not already established). The CRP active component involves a collaborative process in which the therapist invites the participant to share the events, symptoms, and contextual factors leading up to and surrounding their suicidal crisis. Next, the participant identifies their personal warning signs, self-management coping skills, reasons for living, and sources of social support. The participant types the components on a template via the white board feature on doxy.me. The CRP will be saved and serve as a concrete reference for participants in the real-world.

Group II: In-Person Crisis Response Planning Active Control 1 Intervention

The in-person crisis response planning (CRP) session will last between 30 minutes to 1-hour. The in-person CRP will follow the same protocol and include the same treatment components as the virtual CRP. However, it will occur face-to-face, instead of on doxy.me, with a trained study therapist. The treatment components, outlined under the virtual CRP arm description, are written by the participant on an index card. The index card serves as a concrete reference for participants in the real-world.

Group III: Virtual Crisis Risk Counseling Active Control 1 Intervention

The crisis risk counseling session will last between 30 minutes to 1-hour. It will occur virtually on doxy.me with a trained study therapist. It will include the following standard suicide intervention strategies: supportive listening, provision of crisis resources, and referral to a mental health professional (if not already established). The therapist will conduct a semi-structured suicide risk assessment interview, after which participants will complete a self-guided safety plan worksheet via the white board feature. The worksheet will take approximately 10-minutes to complete and will be done independently.

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12429010/

Comparing the Impacts of Crisis Response Plan and Self‐ ... More frequent CRP use was linked with lower risk of suicidal ideation and greater positive affect. This may reflect better plan use due to ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6978712/

The Effectiveness of Crisis Line Services: A Systematic Review Additionally, suicidal urgency decreased in 16% of calls, but increased in 7.8% of calls (33). For this study, suicidal urgency was defined ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S016517812400088X

The effectiveness of a suicide prevention program in ... The suicide rate in the intervention area decreased by 25% following the intervention. Implementation of the LinkPC-PH intervention was associated with ...

4. bmchealthservres.biomedcentral.com bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-11739-w

insights from a randomized control trial of crisis response plan ... In a recently published study [21], it was found that both CRP and self-led SPI were effective in reducing suicide ideation. Follow-up data were ...

5. omh.ny.gov omh.ny.gov/omhweb/statistics/988-legislative-report-2023.pdf

988 Legislative Report - New York State Office of Mental Health Follow-up care reduces suicide risk, supports people in crisis, and is a cost-effective intervention, especially when contrasted with law ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10189833/

Effectiveness of Suicide Safety Planning Interventions Evidence across a range of studies indicates that SSP is effective for reducing suicide behavior (SB) and ideation (SI).

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0005789425000280

A Comparison of In-Person and Digital Suicide Safety ... Results indicate that traditional in-person safety planning and the Safety Planning Assistant produce significantly greater quality safety plans than ...

8. zerosuicide.edc.org zerosuicide.edc.org/toolkit/evidence-base/engage

Engage | Zero Suicide - edc.org Patients at risk for suicide agree to actively engage in a package of evidence-based practices that directly targets their suicidal thoughts and behaviors.

9. msrc.fsu.edu msrc.fsu.edu/blog/msrc-common-data-elements-cde/

Crisis Response Plan (CRP) Results indicated Soldiers who received a CRP were 76% less likely to attempt suicide during the next six months as compared to Soldiers who received standard ...

10. samhsa.gov samhsa.gov/sites/default/files/suicide-risk-practices-in-care-transitions-11192019.pdf

suicide-risk-practices-in-care-transitions- ... The safety plan (Stanley & Brown, 2012) or crisis response plan. (Bryan et al., 2017) is a written strategy for coping with suicidal thoughts.