Expanding Access to Evidence-Based Suicide Risk Assessment and Intervention in a Crisis Stabilization Setting

Browse trials for

• Suicide 701
• Suicide, Attempted 263

Suicide

701 studies on the registry are indexed under Suicide; 183 are open to participants now.

This study's planned enrollment of 80 is below the median of 104 across 560 interventional studies indexed under Suicide.

Lead sponsor

Butler Hospital is the lead sponsor of 114 studies on the registry; 12 are open to participants now.

Study arms

• Experimental
  Jaspr

  Jaspr is a digital platform developed to "increase the delivery of suicide prevention evidence-based practices without adding to personnel needs in an effort to reduce suicidal behavior with an ultimate goal of saving lives." Jaspr includes the following evidence-based components: Comprehensive suicide assessment, crisis stability plans, and lethal means counseling, comfort and skills, and shared stories.

  Behavioral: Jaspr

• No intervention
  Treatment as Usual (TAU)

  Participants in this condition will receive research-related assessments but will not receive Jaspr. Instead, they will receive The Providence Center Crisis Stabilization Unit (CSU) services and post-discharge treatment as usual.

Interventions

• BehavioralJaspr

  Jaspr is a digital platform developed to "increase the delivery of suicide prevention evidence-based practices without adding to personnel needs in an effort to reduce suicidal behavior with an ultimate goal of saving lives." Jaspr includes the following evidence-based components: Comprehensive suicide assessment, crisis stability plans, and lethal means counseling, comfort and skills, and shared stories.

Primary outcomes

1. Number of evidence-based interventions received during crisis stabilization treatment

   Group differences (treatment as usual \[TAU\] vs. Jaspr) in the number of received evidence-based interventions while receiving crisis stabilization treatment. This frequency will be derived from an aggregate of crisis stabilization plans, lethal means counseling, behavioral skills, and shared stories from people with lived experience. The greater the number, the more evidence-based interventions received.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

2. Thoroughness of evidence-based interventions received during crisis stabilization treatment

   Group differences (treatment as usual \[TAU\] vs. Jaspr) in the thoroughness of evidence-based interventions while receiving crisis stabilization treatment. Thoroughness is derived from a 1 (not very thorough) to 5 (very thorough) scale, with higher numbers representing greater thoroughness. This number will be derived from the average thoroughness of four evidence-based interventions: crisis stabilization plans, lethal means counseling, behavioral skills, and shared stories from people with lived experience.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

3. Overall rating of care

   Group differences in overall rating of the care received at the Crisis Stabilization Unit will be measured using a modified Emergency Room-Patient Satisfaction Survey, which assesses patients' overall satisfaction with the visit. This item is assessed on a 5-point rating scale (1=poor, 5=excellent).

   Time frame: Discharge from the crisis stabilization unit

4. Suicide-related coping

   Measured with the Suicide-Related Coping Scale (SRCS), a 17-item self-report measure that examines patients' ability to cope with suicidal thoughts and urges. The SCRS uses a 5-point rating scale from 0=strongly disagree to 4=strongly agree. Thus, higher scores are associated with higher ability to cope with suicidal thoughts and urges.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

5. Intensity of emotional distress

   The investigators will use the Safety and Imminent Distress Questionnaire (SIDQ) - Distress item, where 1=no distress and 10=highest distress ever felt. The SIDQ is based on the Keeping Myself Safe Usability Survey. The value used will be the change from enrollment to discharge.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

6. Extent to which participants felt calm or agitated

   The investigators will use the Safety and Imminent Distress Questionnaire (SIDQ) - Agitation item, where 1=very calm and 10=very frustrated or agitated. The SIDQ is based on the Keeping Myself Safe Usability Survey. The value used will be the change from enrollment to discharge.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

7. Participants' ability to cope with thoughts of killing themselves

   The investigators will use the Safety and Imminent Distress Questionnaire (SIDQ) - Coping ability item, where 1=no ability to cope and 10=strong ability to cope. The SIDQ is based on the Keeping Myself Safe Usability Survey. The value used will be the change from enrollment to discharge.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

8. Participants' readiness to go home

   The investigators will use the Safety and Imminent Distress Questionnaire (SIDQ) - Readiness to go home item, where 1=not able and 10=very able. The SIDQ is based on the Keeping Myself Safe Usability Survey. The value used will be the change from enrollment to discharge.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

9. Suicidal ideation presence

   The investigators will use the Columbia Suicide Severity Rating Scale (C-SSRS) screener at baseline (chart) and 12-week follow-up (clinical interview screener) to measure suicidal ideation presence. This will be coded as a 0=no suicidal ideation or 1=presence of suicidal ideation. The value used will be change from the month prior to enrollment to the month prior to the 12-week post-discharge follow-up assessment.

   Time frame: From enrollment to the end of the study at 12 weeks following discharge

10. Suicidal ideation severity

    The investigators will use the Columbia Suicide Severity Rating Scale (C-SSRS) screener at baseline (chart) and 12-week follow-up (clinical interview screener) to measure suicidal ideation severity. This item is rated from 0 (no suicidal ideation) to 5 (suicidal ideation with intent and plan), with higher scores corresponding to greater suicidal ideation severity. The value used will be change from the month prior to enrollment to the month prior to the 12-week post-discharge follow-up assessment.

    Time frame: From enrollment to the end of the study at 12 weeks following discharge

11. Suicidal behavior composite

    The investigators will use the Columbia Suicide Severity Rating Scale (C-SSRS) screener at baseline (chart) and 12-week follow-up (clinical interview screener) to measure suicidal behavior. Suicidal behavior will be calculated as a composite measure of presence of any suicidal behavior (actual, aborted, and interrupted attempts, preparatory behavior), where 0=no suicidal behavior and 1=suicidal behavior present. The value used will be change from the month prior to enrollment to the month prior to the 12-week post-discharge follow-up assessment.

    Time frame: From enrollment to the end of the study at 12 weeks following discharge

12. Readmissions/revisits

    The investigators will examine the between groups differences in number of suicide-related ED visits, hospitalizations, and crisis services use during the 12-week follow-up period, measured using a modified Treatment History Interview.

    Time frame: From enrollment to the end of the study at 12 weeks following discharge

Secondary outcomes

1. Overall rating of care received by Jaspr

   Participants' overall rating of care received by Jaspr will be measured with an item from the Jaspr Health Patient Satisfaction Questionnaire ("Overall rating of care received by Jaspr"), which is on a scale of 1 (poor) to 5 (excellent). Higher scores represent a higher overall rating of care.

   Time frame: Discharge from the crisis stabilization unit

2. Extent to which providers and staff perceive the use of Jaspr as agreeable or satisfactory (acceptability)

   Extent to which providers and staff perceive the use of Jaspr app in the Crisis Stabilization Unit (CSU) as agreeable or satisfactory. The investigators will use the Acceptability of Intervention Measure (AIM), a 4-item measure to determine whether an evidence-based practice is liked, appealing, welcomed and approved. The IAM is scored on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), with higher scores indicating greater acceptability (range 4 through 20).

   Time frame: Through study completion, average of two years

3. Providers' and staff's perceived fit, relevance, or compatibility of Jaspr (appropriateness)

   Providers' and staff's perceived fit, relevance, or compatibility of Jaspr app with the Crisis Stabilization Unit (CSU), and with their patient populations, measured by the Intervention Appropriateness Measure (IAM). The IAM is a 4-item measure to assess if an evidence-based practice is suitable, fitting, applicable and a good match with the particular setting. The IAM is scored on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), with higher scores indicating greater appropriateness (range 4 through 20).

   Time frame: Through study completion, average of two years

4. Providers' and staff's perceived feasibility of Jaspr (feasibility)

   Extent to which providers and staff feel that Jaspr app can be successfully used or carried out within the Crisis Stabilization Unit (CSU), measured by the Feasibility of Intervention Measure (FIM), a 4-item measure of how doable, easy to use, and implementable a practice is. The FIM is scored on a 5-point Likert scale (1 = completely disagree to 5 = completely agree), with higher scores indicating greater appropriateness (range 4 through 20).

   Time frame: Through study completion, average of two years

5. Amount of time Jaspr is used (reach)

   Amount of time Jaspr is used (in minutes); data is collected from the Jaspr servers.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

6. Number of times Jaspr is accessed (reach)

   Number of times Jaspr is accessed; data is collected from the Jaspr servers.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

7. Percent of Jaspr modules completed (reach)

   Percent of Jaspr modules completed; data is collected from the Jaspr servers.

   Time frame: From enrollment through discharge from the crisis stabilization unit (average length of stay is 5.7 days)

8. Percent of Jaspr participants who activated Jaspr-at-Home companion app (reach)

   Percent of participants in the Jaspr condition who also activated the Jaspr-at-Home companion app.

   Time frame: At the end of the study, 12 weeks following discharge

9. Number of providers and staff trained to use Jaspr (adoption)

   The number of providers and staff trained to use and initiate Jaspr with participants.

   Time frame: Through study completion, average of two years

10. Adverse events associated with the use of Jaspr

    Number of adverse events related to the use of Jaspr. This will be measured using an aggregate including death and participant self-report of life-threatening events, hospitalizations, and medical problems causing a persistent, significant disruption in ability to conduct one's normal life.

    Time frame: From enrollment to the end of the study at 12 weeks following discharge

Individual participant data

Plan to share: Yes — The following types of de-identified data will be shared: (1) demographic data, (2) clinical data, and (3) implementation outcome data. This includes data collected throughout the trial.

Supporting information: Study protocol, Sap, Icf