Motivational Interviewing to Prevent Suicide in High Risk Veterans

描述（由申请人提供）： 本研究的目的是对精神科住院的自杀高危退伍军人进行随机对照试验（RCT）。参与者将从锡拉丘兹VAMC的急性精神病住院部招募。为了达到高风险标准，退伍军人必须在贝克自杀意念量表（SSI）上得分超过2分，这是自杀死亡的前瞻性预测。在提供知情同意书后，参与者将完成筛选评估以确认合格性和自杀风险因素的基线评估。然后，受试者将随机接受动机访谈以解决自杀意念（MI-SI）加常规治疗（TAU）或单独接受TAU。MI-SI组将在住院期间接受两次MI-SI治疗，并在出院后接受一次MI-SI电话加强治疗。两种情况下的参与者将被要求在出院后的一个月、三个月和六个月完成电话随访。主要结局将是通过SSI测量的自杀意念严重程度的变化。探索性分析将检查MI-SI对治疗参与的影响，以及治疗参与作为MI-SI对自杀意念严重程度影响的部分中介。

DESCRIPTION (provided by applicant): The purpose of this project is to conduct a randomized controlled trial (RCT) with psychiatrically hospitalized Veterans who are at high-risk for suicide. Participants will be recruited from the Acute Psychiatric Inpatient Unit at the Syracuse VAMC. To meet high-risk criteria, Veterans must score over two on the Beck Scale for Suicidal Ideation (SSI), which is prospectively predictive of death by suicide. After providing informed consent, participants will complete a screening assessment to confirm eligibility and a baseline assessment of risk- factors for suicide. Participants will then be randomized to receive Motivational Interviewing to Address Suicidal Ideation (MI-SI) plus treatment as usual (TAU), or TAU alone. The MI-SI group will receive two sessions of MI- SI during hospitalization and one MI-SI telephone booster sessions after discharge. Participants in both conditions will be asked to complete telephone follow-up interviews at one, three, and six months after discharge. The primary outcome will be change in the severity of suicidal ideation as measured by the SSI. Exploratory analyses will examine the impact of MI-SI on treatment engagement, and treatment engagement as a partial mediator of the impact of MI-SI on the severity of suicidal ideation.