Please select the eligibility criteria that correspond to the clinical trial below.
Title: Caring Letters for Military Suicide Prevention: A Randomized Controlled Trial
Brief Summary: The purpose of this multi-site randomized controlled trial is to determine if the Caring Letters intervention is effective in preventing suicide and suicidal behaviors among U.S. Service Members and Veterans. The primary aim of this project is determine whether caring communications following inpatient psychiatric treatment reduce suicide and self-inflicted injuries among U.S. military personnel and Veterans. The investigators will also explore treatment utilization by comparing the frequency of treatment visits after enrollment into the study. The following specific hypotheses will be tested:

Hypothesis 1: During a two year follow-up after the index hospital discharge, the frequency of suicide will be lower among participants in the Caring Letters group compared to those in the Usual Care group.

Hypothesis 2: The frequency of medically admitted self-inflicted injuries will also be lower in the Caring Letters group compared to the Usual Care group.

Hypothesis 3: The time to suicidal act, among those who do subsequently exhibit one, will be longer among participants in the Caring Letters group compared to the Usual Care group.


Options:
A: Inclusion Criteria:

* at least 15 years of age
* Inpatient on medical/surgical unit
* Admitted following a suicide attempt
* Sufficient English to benefit from psychotherapy in English
* Consents to be a research participant

Exclusion Criteria:

* Lack of sufficient English to participate in psychotherapy in English
* Prisoner/inmate at time of admission
* Too cognitively impaired, delirious, or psychotic to respond to psychotherapeutic intervention before end of stay on medical/surgical unit. Determination of cognitive impairment, delirium, agitation, and psychosis will be determined through the referral phone call between the PI and the referring care provider, as well as the PI's own clinical assessment of the patient at the outset of the brief intervention.
B: Inclusion Criteria:

* Current psychiatric inpatients
* Possess an active email account
* Informed consent
* Active duty military, Veteran, Retiree, National Guard or Reserves status

Exclusion Criteria:

* Not competent to consent
* Adverse behavioral problems
* The primary psychiatric nurse or attending psychiatrist considers that study to be clinically inappropriate
* Currently under arrest/incarceration
* Involuntary committed for psychiatric care status
C: Inclusion Criteria:

* Self-harm behaviour in the past 6 months
* In receipt of treatment from local Child and Adolescent Mental Health Services
* Competent and willing to provide written, informed consent.

Exclusion Criteria:

* Severe learning disability or pervasive developmental disorder
* Acute psychotic episode
* Eating disorder in the absence of self-harm.
* Non-English speaking
* Current involvement in other ongoing treatment research
D: Inclusion Criteria:

* Patient admitted to Massachusetts General Hospital inpatient psychiatric unit
* Age 18 and older
* Able to read/write in English
* SI documented on admission OR admission due to a suicide attempt
* Admission diagnosis of MDD (and current major depressive episode), confirmed using the Mini International Neuropsychiatric Interview (MINI) and inpatient chart review

Exclusion Criteria:

* Psychotic symptoms, as assessed using the MINI and inpatient chart review
* Cognitive disorder, assessed using a six-item cognitive screen developed for research
* Primary admission diagnosis of substance use disorder

Answer: B