Sarah R. Sullivan

Objective: Suicide-specific group psychotherapy is a novel approach to suicide prevention with promising supporting data. However, limited research examines telehealth delivery for suicide-specific interventions. This study described treatment engagement and suicide-related coping (SRC) trajectories among Veterans receiving a group suicide safety planning intervention before and after a transition from in-person to telehealth delivery. Methods: Project Life Force (PLF) is a group suicide safety planning intervention evaluated within a randomized clinical trial. During the COVID-19 pandemic, PLF transitioned from in-person to telehealth, creating naturalistic pre-pandemic in-person and pandemic-era telehealth cohorts. This report focused on participants randomized to PLF and described treatment initiation, engagement, completion, and SRC trajectories across cohorts. Findings: : Baseline suicidal ideation and SRC were higher in the pre-pandemic in-person cohort than the pandemic-era telehealth cohort. The telehealth cohort showed higher rates of treatment initiation descriptively than the in-person cohort, while treatment engagement and completion among treatment initiators were more similar across delivery periods. Both cohorts showed improvement in SRC that was sustained over time. Conclusions: Elevated treatment initiation occurred with virtual delivery of PLF. Both pre-pandemic in-person and pandemic-era telehealth cohorts showed similar patterns of group engagement as well as development and sustainment of SRC over time. As telehealth can reduce barriers to care, these data lend support to the promise of virtual, group-based, suicide-related interventions. Since treatment modality was determined by the pandemic and not randomized, delivery context, cohort characteristics, and pandemic-related factors may have impacted observed patterns. Randomized studies comparing delivery modalities should clarify potential treatment modality differences.

In 2023, 49,316 people died by suicide in the United States, making suicide the 11th leading cause of death overall and the second leading cause of death among 10–34-year-olds (Centers for Disease ...

Introduction: Limited research has examined the circumstances surrounding childhood suicidal thoughts and behaviors. The interpersonal psychological theory of suicide proposes that suicidal desire arises from perceived burdensomeness and thwarted belongingness, and that suicide attempts result from an acquired capability for suicide. No published study, of which we are aware, has tested whether this theory applies to children’s suicidal thoughts or behaviors. The present study examined whether components of the interpersonal psychological theory of suicide would be present in the narratives of children who presented for clinical care with suicide ideation or attempts. Methods: Thirty-nine children, ages 7–12 years, recruited from two public hospitals and one outpatient clinic, completed semi-structured interviews assessing the circumstances surrounding their recent suicide ideation or attempts. Interviews were analyzed thematically using a hybrid inductive-deductive approach. Results: Findings indicated that thwarted belongingness stemmed from loneliness, perceived rejection, and a lack of reciprocal care. Themes reflecting perceived burdensomeness included internalized criticism, low self-esteem, and perceived liability. Children described experiences, such as physical punishment, that may contribute to acquired capability for suicide. Discussion: These findings support the relevance of the interpersonal psychological theory of suicide in childhood and underscore the critical role caregivers play in protecting children from suicide-related risk.

ObjectivesThis scoping review aims to examine existing research into firearm safety interventions designed to prevent firearm injury and suicide in older adults.MethodsSelect databases were searched in 5/2023. Included articles involved an/a 1. aim to develop or investigate firearm safety interventions, 2. focus on adults 50 years and older, and 3. primary analysis.ResultsThe search yielded 10 articles which primarily focused on firearm safety counseling with older adults with suicide risk or emerging impairment. The review found that older adults may be open to receiving firearm safety counseling but that providers feel ill-equipped to have these conversations and to reliably identify suicide risk. Two studies presented promising data on the impact and acceptability of training providers in a firearm safety intervention. The review also identified the importance of building trust between older patients and providers to have helpful discussions regarding firearms, and highlighted specific approaches that facilitate openness to participate in these exchanges.ConclusionsFurther research into adapting interventions to meet the clinical needs of older adults and treatment efficacy trials is necessary.Clinical implicationsTraining healthcare providers to conduct firearm safety interventions with older adults may be an acceptable and impactful avenue to prevent suicide.

Background: This PRISMA scoping review explored worldwide research on family-based treatments for suicide prevention. Research on this topic highlights the importance of facilitating familial understanding of a suicidal individual. Aim: The review sought evidence of outcomes of trials in which both the patient and family member in the intervention arm attended the same sessions at which suicide was openly discussed. Method: To explore this topic, the authors searched for randomized and nonrandomized controlled trials using Medline (Ovid), PsycINFO (Ovid), Social Services Abstracts (EBSCO), and Web of Science on July 8, 2020. Results: Ten different studies were included that spanned five treatment modalities. Specifically, of the interventions in these 10 articles, 40% employed some sort of cognitive-behavioral therapy, 20% examined attachment-based family therapy, 20% used family-based crisis intervention, and the remaining 20% were distinct interventions from one another. Additionally, several of these articles demonstrated rigorous study methodology and many of the articles reported significant improvements in suicidal ideation or behaviors. Conclusion: Several important research gaps were identified. While this approach has been largely understudied, and to date has been primarily researched in adolescent populations, family interventions have great potential for treatment and prevention of suicidality.

A recent systematic review on family and suicide prevention efforts identified a lack of family-based safety planning interventions for adults. To address this gap, The Safe Actions for Families to Encourage Recovery (SAFER) intervention was created. SAFER is a novel, manualized, 4- session, family-based treatment intervention that provides the tools and structure to support family involvement in Safety Planning Intervention (SPI) for Veterans at moderate risk for suicide. The SAFER intervention includes the use of psychoeducation, communication skills training, and development of a Veteran, and a complementary supporting partner, SPI. This Stage II (2aii) randomized clinical trial (RCT) evaluated the preliminary efficacy of this innovative and much-needed approach. Thirty-nine Veterans and an associated supporting partner were randomized to receive either SAFER or currently mandated (i.e., standard) individual Safety Planning Intervention (I-SPI).

This PRISMA scoping review explored worldwide research on the delivery of suicide-specific interventions through an exclusive telehealth modality. Research over telehealth modalities with suicidal ...