Center for Harmonizing and Improving Interventions to Prevent Suicide (CHIIPS)

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Background: The rate of death by suicide has risen by more than 30% in the past 20 years in the U.S. The rate of death by suicide among U.S. Veterans has risen even faster. Whereas Veterans only constitute 8.5% of the population, they account for 18% of all suicide deaths among U.S. adults. Although recent declines in suicide mortality among Veterans may be cause for some hopefulness, they also obscure the dynamics of suicide mortality and effectiveness of preventive interventions across vulnerable groups. Further, although we do have methods available to stratify individuals by risk level and interventions that can have positive effects in terms of reducing suicide attempts, these tools are far from perfect. There is still an urgent need to determine which available suicide prevention interventions might be the most effective for a given individual at a given time. Significance: The proposed suicide prevention clinical resource center (SP-CRC) is responsive to CSRD’s solicitation of applications from VA research facilities to establish an SP-CRC that will serve suicide prevention investigators by providing highly critical research resources to facilitate programmatic and scientific needs. The mission of our SP-CRC, the Center for Harmonizing and Improving Interventions to Prevent Suicide (CHIIPS), will be to advance a precision medicine approach to suicide prevention research. CHIIPS content area hubs will include Predictive Analytics, Biomarkers, Identification, Screening, Assessment, Social Determinants/Disparities, Interventions, and (v) Training and Education Innovation and Impact: By establishing a VA SP-CRC with an explicit focus on promoting precision medicine for suicide prevention, we will improve individual suicide prevention outcomes, address unsatisfactory response rates for standardized treatments, promote the incorporation of diverse patient presentations, characteristics, and needs into treatment plans and suicide prevention research, improve system and population-level outcomes, and increase efficient use of finite resources (staff, funds, infrastructure). Resources Delivered: At the completion of this project, we will have provided several resources to the VA suicide prevention research community including: 1) a portfolio review of VA suicide prevention research portfolio projects on precision medicine, 2) a dataset repository for use by VA suicide prevention researchers to conduct secondary analyses, 3) the establishment of precision medicine suicide prevention research postdoctoral fellowships, 4) creation and dissemination of several recommendations for clinical trials methodology and safety protocols for suicide prevention research, 5) various precision medicine related educational resources for suicide prevention researchers to promote competent precision medicine suicide prevention research, 6) a statistical and research design consultation service, 7) funding for precision medicine suicide prevention pilot studies or supplemental funding for ongoing studies, 8) a literature review of all precision medicine suicide prevention research to date. Coordination with SPRINT: CHIIPS will work closely with the Suicide Prevention Research Impact Network (SPRINT) PIs and hubs to optimize synergies and avoid duplication of effort between the two centers. Our goal is to enhance current SPRINT activities, by leveraging their network and infrastructure to focus on precision medicine approaches. Together, SPRINT and CHIIPS will help VA Office of Research and Development create a vision and set priorities for as well as build a precision medicine suicide prevention research portfolio that will advance the state of the science and help VA achieve its mission of significantly reducing the number of Veteran suicides.