Suicide is the 11th leading cause of death in the United States, accounting for approximately 34,000 deaths per year [1]. Despite the prevalence, many clinical research trials routinely exclude suicidal individuals due to the lack of appropriate tools and protocols to adequately manage suicide risk. Similarly, clinicians are hesitant to treat suicidal patients, fearing the possibility of legal action by bereft family members should their loved one kill him/herself. The overarching goal of this project is to improve the availability and quality of mental health care for suicidal individuals by: 1) increasing the ability of clinicians'to implement best practice techniques for suicide risk assessment and management, and 2) reducing clinicians' fear of litigation following a suicide by reducing the actual risk of litigatin. This will be accomplished by designing and developing an innovative, web- based tool that guides clinicians through an empirically-derived suicide risk assessment and management protocol, while also providing thorough documentation that suicide risk was managed according to state-of-the- art procedures. Suicide Safety Net: Multimedia Tools for Reliable Risk Management Documentation (SSN) is based on the University of Washington Risk Assessment and Management Protocol (UWRAMP), a tool developed and used extensively by Linehan and colleagues at the UW, and by other treatment outcome researchers working with highly suicidal patients. All content will be thoroughly reviewed and critiqued by a consortium of suicide and forensic experts for accuracy of content. Specific aims for the present Phase I application are as follows. Aim 1: Iteratively develop content and implementation guidelines for a Suicide Safety Net (SSN) prototype utilizing a consortium of forensic suicide experts. Aim 2: Conduct a formative evaluation of the SSN prototype to determine usability, acceptability and perceived barriers to use among target end-users (i.e., clinicians and researchers). Aim 3: Conduct an open feasibility trial with practicing clinicians (N=30) who treat suicidal patients from eight diverse settings to evaluate the SSN prototype and identify additional barriers to use. Pending positive Phase I outcomes, we will: 1) complete development of the full SSN system, 2) produce an e-Learning curricula providing instruction in how to use the SSN in routine clinical practice and within clinical research trials, and 3) conduct a pilot feasibility trial with clinicians in mutiple mental health settings using the full SSN system with suicidal adult clients.
Public Health Relevance Statement: Suicide is the 11th leading cause of death in the United States, accounting for approximately 34,000 deaths per year [1]. Despite the prevalence, many clinical research trials routinely exclude suicidal individuals due to the lack of appropriate tool and protocols to adequately manage suicide risk, similarly, clinicians are hesitant to treat suicidal patients, fearing the possibility of legal action by bereft family members should their loved one kill him/herself. This application seeks to develop, through collaboration with a consortium of suicide and forensic experts, a web-based multimedia tool that will guide clinician users through a state-of-the-art suicide risk assessment and management procedure followed by a thorough best-practice documentation process, with the ultimate hope that use of SSN will: 1) increase clinicians' willingness to treat suicidal clients, 2) improve the quality of suicide rik assessment and intervention when clients are at imminent risk of suicide; and 3) increase the inclusion of suicidal clients in clinical outcome trials.
NIH Spending Category: Behavioral and Social Science; Clinical Research; Mental Health; Prevention; Suicide; Suicide Prevention
Project Terms: Accounting; Address; Administrator; Adult; Attention; base; Cause of Death; Cessation of life; Client; Clinical; clinical practice; Clinical Research; Collaborations; Consult; Consultations; Crisis Intervention; Critiques; Data; Death Rate; design; Development; Doctor of Philosophy; Documentation; Educational Curriculum; Electronics; Elements; Ensure; Evaluation; Event; evidence base; Evidence based intervention; experience; Failure (biologic function); Family member; Feedback; Focus Groups; Forensic Medicine; Fright; Goals; Guidelines; Health Professional; Healthcare; high risk; improved; Individual; innovation; Instruction; Intervention; Interview; Killings; Learning; Legal; Litigation; loved ones; Mental Health; Mission; Monitor; Multimedia; Online Systems; Outcome; Patients; Phase; Prevalence; prevent; Procedures; Process; product development; Protocols documentation; prototype; public health medicine (field); reducing suicide; Research; Research Personnel; Risk; Risk Assessment; Risk Management; safety net; satisfaction; Self Efficacy; success; suicidal; suicidal individual; suicidal morbidity; suicidal patient; suicidal risk; Suicide; Suicide prevention; System; Techniques; Testing; tool; Training; Treatment outcome; United States; Universities; usability; Washington; willingness; Work
