Assessing the Effectiveness of Self- and Clinician-administered Crisis Response Planning for Suicide Risk

Study Overview
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Brief Summary
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The aim of the current project is to compare the use and preliminary effectiveness of a self-administered version of the Crisis Response Plan (CRP) in decreasing suicidal/death ideation and distress and increasing positive affect when compared to a clinician-administered version of the protocol in a sample of 150 military Veterans experiencing current death or suicidal ideation.

Official Title
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Assessing the Effectiveness of Self- and Clinician-administered Crisis Response Planning for Suicide Risk

Conditions
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Suicide, Attempted, Suicidal Ideation

Intervention / Treatment
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* Behavioral: Crisis Response Planning for Suicide Risk


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age or older US military veteran death or suicidal ideation/suicide attempt within the past month Exclusion Criteria: non-Veteran status acute intoxication or active psychosis precluding provision of informed consent inability to communicate and comprehend English residence outside the United States lack of past-month death/suicide ideation or attempt lack of device connected to webcam or internet

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Clinician-administered Crisis Response Plan<br>Clinicians will administer the Crisis Response Plan to 75 military veterans. | Behavioral: Crisis Response Planning for Suicide Risk<br>* Crisis Response Planning is focused on creating personalized set of steps for individuals to follow in case of a crisis and includes individuals' personal warning signs of distress, behavioral coping strategies, reasons for living, social supports to contact, and contact information for professional services, including emergency services. Personalization of the Crisis Response Plan is encouraged, and individuals are instructed to handwrite each step of the Crisis Response Plan on an index card to review.<br>|
| Experimental: Self-administered Crisis Response Plan<br>Participants will complete a self-guided version of the Crisis Response plan online. | Behavioral: Crisis Response Planning for Suicide Risk<br>* Crisis Response Planning is focused on creating personalized set of steps for individuals to follow in case of a crisis and includes individuals' personal warning signs of distress, behavioral coping strategies, reasons for living, social supports to contact, and contact information for professional services, including emergency services. Personalization of the Crisis Response Plan is encouraged, and individuals are instructed to handwrite each step of the Crisis Response Plan on an index card to review.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Suicide Visual Analog Scale scores from the previous daily assessment | The Suicide Visual Analog Scale The S-VAS assesses urge to kill myself using a horizontal line with anchors on the left reflecting none (score: 0) and on the right reflecting extreme (score: 100). The S-VAS is initially presented with the indicator on the none position, and non-movement of the indicator is followed by a prompt to remind the participant to move the indicator, if relevant, to ensure response accuracy. Higher scores are indicative of greater severity | Administered daily for eight consecutive days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Patient Health Questionnaire - 2 scores from the previous daily assessment | The PHQ-2 is a 2-item measure of depression symptom severity adapted from the 9-item version of the PHQ (Kroenke & Spitzer, 2002). Item responses are scores on a Likert scale ranging from 0 to 3. Total scores range from 0 to 6, with higher scores indicating greater symptom severity. | Administered daily for eight consecutive days | 
| Change in Positive and Negative Affect Schedule - Short Form scores from the previous daily assessment | The Positive and Negative Affect Schedule - Short Form a 20-item validated self-report measure of state positive and negative affect. The measure contains two, 10-item subscales measuring positive and negative affect, respectively. Possible total scores for each subscale range from 10 to 50, with higher scores indicating greater state affect. | Administered daily for eight consecutive days | 
| Change in Crisis Response Plan Use from the previous daily assessment | - In order to assess whether CRP use after completion impacts suicide urges and affect, participants will be instructed to Please list all dates and times that you used part or all of the Crisis Response Plan that you completed since you last completed this survey. (or since you completed your Crisis Response Plan if this is the first survey you will complete) You may provide us with your best estimates of dates and times. | Administered daily for eight consecutive days |