Caring E-mails for Military and Veteran Suicide Prevention: A Randomized Controlled Trial

Area of Science:

• Mental Health Research
• Suicidology
• Military Health Systems

Background:

• Suicide remains a critical concern among U.S. service members and veterans.
• Previous interventions, like Caring Letters (CL), have shown promise in reducing suicide risk.
• The need for accessible, scalable suicide prevention strategies in military populations is high.

Purpose of the Study:

• To evaluate the efficacy of an e-mail-based Caring Letters (CL) intervention for suicide prevention.
• To determine if the CL intervention reduces suicide behaviors in U.S. service members and veterans.
• To assess the feasibility and safety of delivering the CL intervention in military healthcare settings.

Main Methods:

• A randomized controlled trial involving 1,318 psychiatric inpatients from military and VA hospitals.
• Participants were randomized to receive 13 e-mail interventions over two years or usual care.
• Outcomes included all-cause mortality, hospital readmissions, and self-reported suicide attempts.

Main Results:

• No statistically significant differences were found between the CL group and usual care group in suicide deaths or all-cause mortality.
• There were no significant differences in hospital readmissions or self-reported suicide attempts between groups.
• The intervention was feasible to implement and had no associated adverse events.

Conclusions:

• The study was inadequately powered to make firm conclusions about the efficacy of the e-mail CL intervention.
• The findings suggest the intervention is feasible and safe for military and veteran populations.
• Methodological considerations for future caring contact trials in military settings were highlighted.