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A Pilot Randomized Trial of a Brief Intervention to Prevent Suicide After Inpatient Psychiatric Discharge
Natalie B Riblet1, Susan P Stevens1, Bradley V Watts1
1U.S. Department of Veterans Affairs (VA) Medical Center, White River Junction, Vermont (Riblet, Stevens, Watts, Forehand, Cornelius, Powell, Lewicki, Shiner); Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (Riblet, Stevens, Watts, Gui, Powell, Lewicki, Shiner); VA Office of Systems Redesign and Improvement, White River Junction, Vermont (Watts); National Centre for Suicide Research and Prevention of Mental Ill-Health, and World Health Organization Collaborating Centre for Research, Methods, Development and Training in Suicide Prevention, Karolinska Institutet, Stockholm (Wasserman).Send correspondence to Dr. Riblet (natalie.bv.riblet@dartmouth.edu).
Objective:
Risk for suicide is high after psychiatric hospitalization. The World Health Organization's Brief Intervention and Contact (BIC) program has shown efficacy in preventing suicide. A version adapted for the U.S. Department of Veterans Affairs (VA) was studied to determine preliminary effects.
Methods:
Patients receiving psychiatric hospitalization because of acute risk for self-harm were randomly assigned to the VA BIC or standard care alone. Effect sizes (Hedges' g) for suicidal ideation (primary outcome), social connectedness (measured as thwarted belongingness and perceived burdensomeness), hopelessness, and engagement were calculated at 1 and 3 months.
Results:
Patients were randomly assigned to the VA BIC (N=10) or standard care (N=9). The VA BIC had a medium or large effect on most measures at 1 month (suicidal ideation, g=0.45). Effects diminished at 3 months, except for thwarted belongingness (g=0.81).
Conclusions:
The VA BIC had meaningful effects on suicide-related outcomes. The largest effect was seen in the first month.
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