efficacy, effectiveness, and implementation of jaspr health in emergency department- part a

Conditions: Suicidal Ideation; Suicide Attempt; Self Harm

Summary: this study will comprehensively evaluate a multi-component suicide prevention technology (jaspr health) that facilitates delivery of suicided-related evidence-based practices (ebps) while replacing wasted waiting time with productive time in the emergency departments (eds). the ebps satisfy several key performance elements for systems adopting zero suicide. a complementary randomized controlled trial and real-world study for efficacy, effectiveness, and implementation study design (creid) will be used

this study will evaluate jaspr's patient-facing tablet-based application (app) during suicide-related ed visits. the app guides patients in completing the suicide status interview, which comprise of an evidence-based collaborative assessment \& management of suicidality (cams) certified suicide prevention tools such as a suicide risk assessment, stanley brown- inspired safety planning, and lethal means safety counseling. it also offers access to a menu of "comfort and skills" modules that teaches patients behavioral skills to effectively manage imminent distress, while shared stories offer a library of professionally produced, racially and culturally diverse, inspirational videos of people with suicide-centered lived experience. subjects who interact with jaspr can continue to access their safety plan, comfort and coping skills exercises, and the video library via jaspr at home (jah) mobile application; a summary of the self-administered risk assessment is shared with the clinical team directly through the patient electronic medical record to help guide the treatment plan. part a of the study will be an individual, patient-level randomized controlled trial (rct) to evaluate the efficacy and mechanism of action of jaspr's app intervention in eds. all subjects will complete a baseline assessment prior to random assignment to one of the the two study conditions. all subjects will receive follow-up phone calls for 12 months after enrollment at weeks 6, 12, 24, 36, and 52. these calls will assess suicide related outcomes and healthcare utilization. in addition, the massachusetts department of public health (ma dph) death registry will be reviewed, and each subject's electronic health record will be reviewed. part b of the study will be a real-world study (rws) to evaluate the effectiveness and implementation processes in eds and outcomes. this clinicaltrials.gov record will cover only part a. part b is summarized in a separate entry.

Eligibility criteria:
inclusion criteria: * positive for suicide risk on the patient safety screener in the ed (active suicidal ideation int the past 2 weeks, or suicidal attempt in the past 6 months) * cognitively and emotionally capable of consent and engaging in jaspr app. * reads english at 6th grade level. * reliable telephone access. * owns a smart phone * lives in massachusetts exclusion criteria: * prisoners or in state custody * adults unable to consent * patient \<18 yeas * enrolled subjects during the 12 month follow-up period

Keywords: suicide self-harm attempt ideation suicidal thought suicidal plan crisis intervention suicide prevention emotional support mental health behavioral health psychiatry emergency department technology mobile application implementation safety plan lethal means