Evaluation of the "Coping Long Term with Active Suicide Program"

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DESCRIPTION (provided by applicant): Suicide and attempted suicide are major public health issues in the United States, with suicide accounting for more than 36,000 deaths in the year 2009, and over 500,000 attempt suicide each year. Although recent years have seen significant advances in our knowledge of efficacious treatments for many psychiatric disorders, the suicide rates in this country have not decreased substantially. Despite the high public health significance of suicide and the apparent inability of our current psychiatric treatments to influence suicide rates, there has been relatively little research devoted to developing or testing interventions that directly target suicidal behavior. Developing and evaluating new interventions to reduce suicidal behavior has been recognized as a priority area by NIMH, CDC and the recently released 2012 National Strategy for Suicide Prevention. Supported by previous treatment development grants, we have developed a new intervention as an adjunct to community treatment specifically designed to reduce suicidal behavior among high-risk populations This intervention, "Coping Long Term with Active Suicide Program" (CLASP) is an innovative, telephone based intervention, which combines elements of individual psychotherapy, case management and significant other/family therapy. Pilot data on the CLASP intervention have been quite promising. Patients admitted to a psychiatric hospital due to suicide risk who received CLASP had two-thirds fewer suicide attempts than those receiving a control condition during a six month follow-up following hospital discharge. This application proposes to conduct a larger scale clinical trial evaluating the effects of the adjunctive CLASP intervention to reduce suicidal behavior. More specifically, we propose to randomly assign 232 patients admitted to a psychiatric hospital due to a suicide attempt or suicide risk to either the CLASP intervention or an Safety Assessment and Follow-up Evaluation (SAFE) comparison, both delivered as adjuncts to community treatment as usual. We propose to conduct follow-up assessments at both at the end of the active intervention phase (6 months post-discharge from hospital) and again at 9 and 12 months post discharge.