A Brief Intervention to Reduce Suicide Risk in Military Service Members and Veterans- Study 1
Condition: Suicide Risk | Patient
MeSH terms: Suicide
Study type: Observational

Summary: 
      The investigators propose to evaluate Suicide Assessment and Follow-up Engagement: Veteran
      Emergency Treatment (SAFE VET) which is currently being implemented in 4 VA ED/Urgent Care
      Units across the United States (Portland VA Medical Center (VAMC), Denver VAMC, Manhattan
      VAMC, and Philadelphia VAMC).
    

Detailed description: 
      Background: In 2009, a novel clinical demonstration project entitled Suicide Assessment and
      Follow-up Engagement: Veteran Emergency Treatment (SAFE VET) was initiated as a potential
      standard of care for suicidal Veterans who receive treatment at Veterans Affairs (VA)
      emergency departments (ED). SAFE VET is designed to attenuate suicide risk by helping
      Veterans manage suicidal thoughts and behaviors, and adhere to prescribed clinical care;
      thereby promoting resiliency and increased capacity to cope with suicidal states.

      Objectives: Using a quasi-experimental design, the aim of this study is to compare the
      effectiveness of the SAFE VET intervention versus enhanced usual care (E-CARE)on the
      following: 1) the proportion of patients who attempt suicide within 6 months of index
      emergency department (ED) visit; 2) the severity of suicide ideation within 6 months after
      index ED visit; 3) the proportion of patients who attend > 1 outpatient mental health or
      substance abuse treatment appointments within 30 days following index ED visit; and 4) the
      degree of suicide-related coping for attending treatment during the 6 month period.

      Methodology: Six hundred Veterans, up to 300 per condition (SAFE VET or E-CARE), who meet
      inclusion/exclusion criteria will be enrolled. E-CARE sites are as follows: Long Beach VAMC,
      Bronx VAMC, Milwaukee VAMC, and San Diego VAMC. All subjects will participate in an
      approximately 1-hour long baseline assessment battery (index ED visit) by phone, and will be
      contacted by phone at approximately 1, 3, and 6 months after the index ED visit to complete
      follow-up measures. Medical records will also be reviewed to determine VA health service
      usage in the six-month period after study enrollment.
    

Intervention name(s): SAFE VET
Intervention type(s): Behavioral
Intervention description(s): All SAFE VET EDs provide a standardized intervention that is specifically adapted for use in the ED to mitigate suicide risk. Given that the SAFE VET intervention was developed for use in a busy ED setting, the length of the intervention is approximately 45 minutes. The SAFE VET intervention is administered by a clinical provider who has been specifically trained and consists of:
Risk Assessment
Safety Planning Intervention: Developed by Stanley and Brown (2008), Safety Planning Intervention consists of a hierarchically-arranged list of coping strategies identified for use during a subsequent suicidal crisis.
Clinical Follow-Up Protocol
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Veterans who were seen in a VA Emergency Department and were identified as being at risk
        for suicide.