Effectiveness of a Targeted Brief Intervention for Recent Suicide Attempt Survivors

对近期自杀未遂幸存者进行有针对性的短期干预的有效性

• 批准号: 10408002
• 负责人: Anthony R Pisani
• 金额: $ 65.5万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-20 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10408002
• 关键词: Accounting; Address; American; Award; Belief; Caring; Clinical; Clinical Sciences; Communities; Cost Effectiveness Analysis; Data; Distress; Effectiveness; Emergency Situation; Emergency medical service; Evaluation; Feeling; Finland; Funding; Future; Goals; Grant; Health system; Healthcare Systems; Human Resources; Individual; Inpatients; Intervention; Interview; Investigation; Investments; Leadership; Learning; Length of Stay; Loneliness; Mediating; Mediation; Medical Records; Mental Health; Mental Health Services; Modeling; National Institute of Mental Health; New York; Participant; Patient Education; Patients; Perception; Persons; Protocols documentation; Provider; Public Sector; Randomized; Randomized Controlled Trials; Recovery; Reporting; Request for Applications; Research; Research Personnel; Research Support; Risk; Safety; Savings; Services; Shame; Statistical Data Interpretation; Suicide; Suicide attempt; Suicide prevention; Survivors; Sweden; Switzerland; System; Testing; Therapeutic; Time; Training; United States Substance Abuse and Mental Health Services Administration; Visit; Work; World Health; arm; base; brief intervention; cost; cost effective treatment; cost effectiveness; cost estimate; cost-effectiveness ratio; design; effectiveness evaluation; effectiveness research; effectiveness study; effectiveness testing; efficacy trial; experience; follow-up; group intervention; hospital utilization; improved; incremental cost-effectiveness; inpatient service; insight; interest; intervention cost; intervention program; novel; novel therapeutics; patient engagement; program costs; programs; psychologic; reducing suicide; response; suicidal; suicide rate; theories; treatment arm; treatment as usual; treatment effect; treatment services

Suicide rates are rising in the US and more than a million Americans try to take their own lives each year. Effective, brief, low-cost interventions for individuals who attempt suicide are essential to saving lives and achieving the goals of the National Strategy for Suicide Prevention. This proposal takes advantage of a time- sensitive research opportunity to test the effectiveness of the Attempted Suicide Short Intervention Program (ASSIP), a manualized 3-session intervention for recent suicide attempt survivors that produced dramatic reductions in suicide attempts in a efficacy trial–80% fewer reattempts and an average of 72% fewer hospital days over 24 months in the intervention group compared to controls. Our research will now test its effectiveness of in the US public mental health care system, examine theoretically grounded mechanisms, and explore cost-effectiveness. ASSIP is currently being implemented by New York State in a Zero Suicide initiative funded by SAMHSA. Consistent with NIMH Notice of Interest MH-17-031, our project leverages this federal investment and a strong state partnership to conduct effectiveness research. Our project has three aims: Aim 1. Effectiveness. The primary aim of this study is to determine the effectiveness of ASSIP in reducing suicide reattempts in a community mental health setting in the U.S. To accomplish this aim we will conduct a randomized controlled trial with 400 individuals referred from psychiatric inpatient and emergency services following a suicide attempt. Participants will be randomized to receive either usual care + ASSIP (intervention arm) or usual care only (control arm), and followed for assessments at baseline, 3, 6, 12, and 18 months. Aim 2. Mechanism. The secondary aim of this study to examine the psychological mechanisms of ASSIP as predicted by the Interpersonal Theory of Suicide. We will conduct statistical analyses of a mediation model to determine (a) whether ASSIP improves perceptions of low belonging and being a burden on others, and (b) whether the effect of treatment on reductions in suicide re-attempts is mediated by these improvements. Aim 3. Cost-Effectiveness. The exploratory aim of this study is to estimate, from the perspective of an ASSIP provider, the incremental cost per suicide attempt averted by delivering ASSIP to supplement usual care following a suicide attempt. We will gather pre-implementation accounting data, personnel time logs, and 12- month medical record reports of emergency and inpatient psychiatric visits. We will use these data together with effectiveness results to calculate the incremental cost-effectiveness ratio (ICER). This time-sensitive study builds effectiveness research into a federally-funded Zero Suicide grant to New York state, consistent with a specific request from NIMH for such applications. If hypotheses are supported, the study will provide evidence of a brief, practical, and novel therapy that reduces suicide reattempts in a real-world health setting. If hypotheses are supported, the study will provide evidence of a brief, practical, and novel therapy that reduces suicide reattempts in a real-world health setting.

美国的自杀率正在上升，超过一百万的美国人试图结束自己的生命