Caring Letters for Military Suicide Prevention

National Center for Telehealth and Technology

Status: Completed

Conditions: Suicide, Attempted; Suicide

Treatments: Behavioral: Caring Letter (email)

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT01473771

MOMRP (Other Grant/Funding Number)

W81XWH-11-2-0123

Details and patient eligibility

About

The purpose of this multi-site randomized controlled trial is to determine if the Caring Letters intervention is effective in preventing suicide and suicidal behaviors among U.S. Service Members and Veterans. The primary aim of this project is determine whether caring communications following inpatient psychiatric treatment reduce suicide and self-inflicted injuries among U.S. military personnel and Veterans. The investigators will also explore treatment utilization by comparing the frequency of treatment visits after enrollment into the study. The following specific hypotheses will be tested:

Hypothesis 1: During a two year follow-up after the index hospital discharge, the frequency of suicide will be lower among participants in the Caring Letters group compared to those in the Usual Care group.

Hypothesis 2: The frequency of medically admitted self-inflicted injuries will also be lower in the Caring Letters group compared to the Usual Care group.

Hypothesis 3: The time to suicidal act, among those who do subsequently exhibit one, will be longer among participants in the Caring Letters group compared to the Usual Care group.

Full description

This social/ behavioral study is a five year multi-site randomized controlled trial that will compare the Caring Letters intervention (with usual care) to usual care without the caring letters. Participants will be recruited from inpatient psychiatry units of collaborating military and Veterans Affairs (VA) sites and randomized to either a group that receives letters (Caring Letters group) or a group that does not receive letters (Usual Care group). The methodology of the intervention is updated with emails instead of postal letters. This study fills an important gap in the evidence base for the Caring Letter intervention through a methodologically rigorous research design.

Enrollment: 1,319 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Current psychiatric inpatients
• Possess an active email account
• Informed consent
• Active duty military, Veteran, Retiree, National Guard or Reserves status

Exclusion criteria

• Not competent to consent
• Adverse behavioral problems
• The primary psychiatric nurse or attending psychiatrist considers that study to be clinically inappropriate
• Currently under arrest/incarceration
• Involuntary committed for psychiatric care status

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,319 participants in 2 patient groups

Caring Letter Condition (CL)

Experimental group

Description:

In the Caring Letters (CL) group, participants will be emailed "letters" for two years on a planned schedule. The emailed letters are simple expressions of care and include standard contact information for available health care services.

Treatment:

Behavioral: Caring Letter (email)

Usual Care (UC)

No Intervention group

Description:

The participants in the Usual Care (UC) group will not receive the emails.