Suicide Prevention Program for Veterans Discharged From Community Care Settings

Not Applicable

Active, not recruiting

• Conditions: Suicide Prevention
• Interventions: Other: Standard Mental Health Care; Behavioral: BESST

• Registration Number: NCT06139887
• Lead Sponsor: White River Junction Veterans Affairs Medical Center

Brief Summary

The goal of this pilot randomized controlled trial is to test an adapted suicide prevention program (the Building VA Engagement, Self-efficacy, and Social Support To Prevent Suicide or BESST) in rural Veterans discharged from community care mental health treatment settings. The main question it aims to answer is:

* Does BESST combined with standard care improve suicide-related outcomes among this population compared to standard care alone?

Participants will be assigned by change to a treatment group. Some will receive the BESST intervention combined with standard care, and some will receive standard care alone. All participants will be in this research study for up to three months.

Those receiving the BESST intervention will have:

* 1 one-hour brief educational session;

* Seven follow-up check-ins (\~30 minutes each)

All participants will have three assessment interviews where they will be asked about their mental health and treatment received outside of the VA.

The investigators will compare participants assigned to the BESST intervention combined with standard care vs participants assigned to standard care alone to see if the BESST intervention improves suicide-related outcomes.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-10-01
• Study First Submitted: 2023-11-14
• Study First Submitted QC: 2023-11-14
• Study First Posted: 2023-11-18
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-03
• Last Update Posted: 2025-03-04
• Primary Completion: 2025-04-30
• Study Completion: 2025-06-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 25

Inclusion Criteria

• The patient was recently discharged from a VA community care mental health treatment setting
• The patient is at risk for self-harm
• Be a patient connected to the White River Junction VA Medical Center (VAMC), the Togus VA Medical Center (VAMC), or the Manchester VA Medical Center (VAMC);
• Be a Veteran;
• Be 18 years or older;
• Be able to speak English;

Exclusion Criteria

• Unable to provide informed consent;
• The investigators do not plan to enroll any potentially vulnerable populations including prisoners, institutionalized patients, or involuntarily committed patients;
• Study physician deems the patient not clinically appropriate

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control	Standard Mental Health Care	Patients randomized to the control arm will receive standard mental health care alone.
BESST	BESST	Patients randomized to the BESST intervention arm will receive the BESST intervention combined with standard mental health care.
BESST	Standard Mental Health Care	Patients randomized to the BESST intervention arm will receive the BESST intervention combined with standard mental health care.

Primary Outcome Measures

Name	Time	Method
Suicidal Ideation: The Beck Scale for Suicidal Ideation (BSS)	Baseline to 3 months post-discharge	The Beck Scale for Suicidal Ideation (BSS) ranges from 0-38. While there is no established BSS cutoff score to classify suicide risk, there is evidence that higher scores on the BSS correspond to more severe suicidal ideation and that a change of five points or more on the total BSS scores may be clinically relevant.

Secondary Outcome Measures

Name	Time	Method
Hopelessness: Beck Hopelessness Scale (BHS)	Baseline to 3 months post-discharge	The Beck Hopelessness Scale (BHS) is a 20-item self-report scale that assesses hopelessness over the past seven days. Patients report on feelings about the future, loss of motivation, and future expectations. Total scores range from 0 to 20, with higher scores suggesting more hopelessness. The BHS has good reliability and validity and is sensitive to change. There is some evidence that the BHS may be a measure of risk of suicide.
Patient Engagement: Suicide-Related Coping Scale (SRCS)	Baseline to 3 months post-discharge	The Suicide-Related Coping Scale (SRCS) includes 17 questions related to a patient's perception of their ability to cope with suicidal thoughts. Each item is assessed using a 5-point Likert scale. The scale includes two subscales including an External Coping subscale and an Internal Coping Subscale. The score range for the entire scale is 0-68 with the External Coping being 0-28 and the Internal Coping being 0-28. Higher scores indicate increased perception of suicide-related coping.
Connectedness: Interpersonal Needs Questionnaire-15 (INQ-15)	Baseline to 3 months post-discharge	The Interpersonal Needs Questionnaire-15 (INQ-15) is a 15-item self-report scale that measures thwarted belongingness (9 items) and perceived burdensomeness (6 items). Each item is measured on a 7-point Likert scale, with higher scores suggesting lower perceived connectedness. The score range for the entire scale is 15-105, with the score range for perceived burdensomeness being 7-49.
Suicide Attempts: Columbia-Suicide Severity Rating Scale (C-SSRS)	Baseline to 3 months post-discharge	The Columbia-Suicide Severity Rating Scale (C-SSRS) is a valid and reliable scale that includes a seven-item subscale that asks patients to self-report on actual attempts, interrupted attempts, aborted attempts, and preparatory acts or behaviors. The scale asks the assessor to document the actual and potential lethality of these behaviors. There are two subscales within the C-SSRS: suicidal ideation (range: 0-5, with higher scores suggesting increased suicidal ideation) and intensity of ideation (range: 0-25, with higher scores suggesting increased intensity).
Patient Engagement: General Self-Efficacy Scale (GSES)	Baseline to 3 months post-discharge	The General Self-Efficacy Scale (GSES) is a valid scale of self-efficacy that is designed for the general population (12 years or older) and it has been tested in various countries. It is a 10-item psychometric scale that is designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life. Total scores range from 10 to 40, with higher scores suggesting increased self-efficacy.
Substance Use: Timeline Follow Back (TLFB)	Baseline to 3 months post-discharge	The investigators will assess substance use at baseline and follow-up assessments using a timeline follow-back approach. This method is commonly used in research studies to assess substance use patterns. Numerical scores do not apply to this assessment.

Trial Locations

Locations (1)

White River Junction VA Medical Center; 🇺🇸 White River Junction, Vermont, United States