Title: The Mental Imagery for Suicidality in Students Trial (MISST): A feasibility study.
Funder: Department of Health and Social Care

Abstract: In the UK, suicide is the leading cause of death in young people and have increased in recent years. Areas in the North of England appear particularly at risk. University students represent one vulnerable group. 42% of students contemplate suicide in any one-year period. Suicidal thinking is an important indicator of distress and clinical need, which predicts subsequent suicidal experiences and worse mental health. It is therefore an important target for clinical treatment and early intervention. However, evidenced based interventions for targeting suicidal thinking in students are lacking. This project will evaluate the feasibility of a novel psychological intervention, called the Broad Minded Affective Coping (BMAC) intervention. The BMAC aims to increase peoples access to positive thoughts and emotions to help them to break out of cycles of negative mood and suicidal thinking. It is targeted, protocolised, and deliverable by a range of professional groups. Our existing co-development work with young people has suggested that it is acceptable and helpful to University students. We aim to conduct a randomised controlled feasibility trial of the BMAC intervention for suicidal thinking in university students. Participants will be randomised to either a risk assessment and signposting plus the BMAC (n = 33), or risk assessment and signposting alone. We will assess outcomes at baseline and after eight weeks, 16 weeks, and 24 weeks. We will explore the safety, feasibility and acceptability of delivering the intervention and trial procedures. Embedded qualitative interviews with staff and participants, and field notes, will help us to understand the potential factors affecting acceptability and delivery of the BMAC intervention and conduct of the trial, and the proposed underlying mechanisms of change. The project will be a crucial step in evaluating the BMAC for suicidal students, paving the way for a larger trial of clinical effectiveness.

Lay abstract: Suicide is the main cause of death in young people. Many students experience suicidal thoughts. These thoughts can be distressing. They can lead to suicide attempts and worse mental health. University and NHS services typically manage this risk. However, there are few treatments for targeting suicidal thinking in students. We want to evaluate a new talking therapy called the Broad-Minded Affective Coping (BMAC) intervention. It is brief, structured, and easily used by student services. The BMAC asks people to revisit and focus on positive memories and experiences. This may help people to break out of cycles of suicidal thinking. We have piloted the BMAC in 11 students. They reported fewer suicidal thoughts after the BMAC. There was no evidence of any harm to participants. We refined the BMAC based on the feedback that we received. We now want to see whether we can do a larger study of the BMAC. We will recruit 66 students with suicidal thoughts to a clinical trial. We will randomly assign 33 students to receiving risk assessment and signposting. The other 33 students will receive risk assessment and signposting plus the BMAC. We will assess students suicidal thinking and other difficulties at the start of trial and after eight, 16 and 24 weeks. We will explore whether young people are happy to complete the clinical assessments and the BMAC. We will interview students and staff as they finish the trial. Staff will also keep detailed notes of their experiences. This will help us to understand how people found the therapy and the trial. The results will improve the BMAC for young people. It will help to plan a larger study. We will work with young people to decide how to best share our findings. Passive sentences 0% Reading Ease 64.7 Grade Level 6.9

Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH