Group-Based Suicide Safety Planning and Skills Training for Veterans With High Suicide Risk: A Randomized Clinical...

Area of Science:

• Psychiatry
• Clinical Psychology
• Public Health

Background:

• Rising suicide rates among veterans necessitate novel, evidence-based treatments.
• Suicide safety planning (SSP) is a critical component of suicide prevention.
• Augmenting SSP with skills training may enhance its effectiveness.

Purpose of the Study:

• To evaluate Project Life Force (PLF), a group intervention combining SSP with skills training.
• To compare the efficacy of PLF plus treatment as usual (TAU) versus TAU alone in reducing suicidal behavior in high-risk veterans.

Main Methods:

• Multisite randomized clinical trial with 207 high-risk veterans.
• Intervention group received PLF (10-12 sessions) plus TAU.
• Control group received TAU alone (individual SSP and standard outpatient care).
• Primary outcome: time to first suicidal behavior over 12 months.
• Secondary outcomes: hopelessness, depression, coping, help-seeking attitudes.

Main Results:

• No significant difference in time to overall suicidal behavior between groups.
• PLF group showed a significantly lower hazard of actual suicide attempts (HR, 0.49; P=.03).
• PLF significantly improved suicide-related coping at posttreatment and 6-month follow-up.
• No study-related adverse events were reported.

Conclusions:

• PLF plus TAU did not alter the time to overall suicidal behavior.
• PLF demonstrated efficacy in reducing actual suicide attempts and enhancing suicide-related coping skills.
• The findings suggest that augmenting SSP with skills training can improve outcomes for veterans at high risk for suicide.