Men and Providers Preventing Suicide (MAPS)
Condition: Suicidal Intention; Suicidal Ideation; Suicide, Attempted
MeSH terms: Suicide; Suicidal Ideation; Suicide, Attempted
Study type: Interventional

Summary: 
      This study will determine if suicidal middle-aged men who use a personalized computer program
      addressing suicide risk before a primary care visit are more likely to discuss suicide and
      accept treatment, reducing their suicide preparatory behaviors and thoughts.This is important
      because half of all men who die by suicide visit primary care within a month of death, yet
      few broach the topic, missing chances for prevention.
    

Detailed description: 
      In this study, the investigators will enroll middle-aged men with active suicide thoughts in
      a randomized controlled trial (RCT) to examine whether their use of the Men and Providers
      Preventing Suicide (MAPS) tailored interactive multimedia patient activation program
      immediately before a primary care provider (PCP) visit, linked with integrated telephone
      evidence-based follow-up care (TEBFC) (vs. attention control exposure linked with TEBFC),
      reduces suicide preparatory behaviors and ideation over 3 months. About half of all
      middle-aged men who die by suicide are seen by a PCP within a month of dying, suggesting the
      value of primary care-based suicide prevention efforts, to complement strategies in other
      settings. Current impediments to primary care-based prevention are that many suicidal
      middle-aged men do not visit a PCP, and among those who do the topic of suicide is rarely
      broached, due to societal gender-linked norms (e.g., toughness); stigma; spurious concerns
      that talking about suicide increases risk; competing time demands; and lack of resources to
      cope with positive responses. PCP-targeted educational interventions have increased detection
      of suicidal men, but have inconsistently affected suicide behaviors, and still many suicidal
      men went undetected. Suicide behaviors are more likely to be reduced by evidence-based
      follow-up care - supportive follow-up contact and collaborative mental health care. However,
      such care can only be effective if at-risk men visit a PCP who identifies suicide risk and
      offers the care, and the men accept it. Thus, there is a pressing need to study the use of
      innovative tools like MAPS to activate at risk middle-aged men to signal their receptiveness
      to suicide discussion and care, prompting PCP inquiry and referrals to a form of follow-up
      care that is feasible for most practices to implement (e.g., TEBFC).
    

Intervention name(s): MAPS tailored multimedia patient activation program; Sleep hygiene video; Telephone evidence-based follow-up care; Commitment to Living for Primary Care
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): 3 minute video on sleep hygiene produced by HealthiNation; 3 months of suicide-focused collaborative mental health care, directed by a supervising psychiatrist and implemented by a care manager working with the patient and their primary care provider; Brief (30 minutes total time) video modules presenting participating patients' primary care providers with a patient-centered framework for suicide risk assessment and intervention
Other intervention name(s): TEBFC
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment