COLUMBUS, Ohio — Suicide is one of the top two causes of death in the military, and suicide rates among this population have increased over the past 20 years.
Department of Psychiatry and Behavioral Health.
The Augmenting Suicide Prevention Interventions for Servicemembers (ASPIS) collaboration proposes to address this overarching challenge by conducting five synergistic studies guided by a common overarching question: which strategies, implemented how, by whom and under what circumstances, are most effective for which member services?
“Overall, the insights gained from our five studies will preserve and sustain military readiness, improve service members’ quality of life, and prevent suicidal tendencies by improving our ability to deliver the right interventions to the right service members at the right time,” Bryan said. , principal investigator of the Suicide and Injury Reduction Initiative for Veterans (STRIVE) in Ohio State.
STRIVE is one of the nation’s leading research sites for clinical trials in suicide treatment, prevention and intervention. The nationally recognized team conducts research, education, awareness and advocacy to improve the lives of military personnel, veterans, first responders and their families.
Each of the five research projects focuses on an empirically supported strategy that has been shown to be effective in preventing suicidal behaviors among military personnel in at least one randomized clinical trial. Projects will be conducted in a variety of settings, including primary care, outpatient mental health, emergency services, and the community, with a diverse array of military recruits from all branches of service.
- Project 1 involves a two-stage study to develop and test a treatment prognosis calculator to identify members of suicide services who are likely to respond well to typical mental health treatment and who should instead receive brief cognitive behavioral therapy to suicide prevention, a specialized treatment that has been shown to reduce suicide attempts in the military by 60%. This project will be led by Jay Fournier, director of the Mood and Anxiety Program at the Ohio State Department of Psychiatry and Behavioral Health. It will be conducted on three military bases: Lackland Air Force Base in Texas, Wright-Patterson Air Force Base in Ohio and Joint Base Andrews in Maryland.
- Project 2 is a clinical trial to test the effectiveness of brief cognitive behavioral therapy for suicide prevention delivered via a smartphone app, to reduce suicidal ideation and suicide attempts among service members seeking treatment in primary care clinics. Service members will be assessed repeatedly over a year to determine whether use of the app reduces suicidal tendency compared to treatment as usual. The study will be conducted at primary care clinics in Fort Carson, Colorado.
- Project 3 is a clinical trial to assess the impact of crisis response planning training for emergency department clinicians. In this study, emergency department clinicians will be randomly assigned to participate in a crisis intervention planning workshop with follow-up consultation and support. Crisis Response Planning is a brief intervention that has been proven to reduce suicide attempts among military personnel by 76%. Service members will be repeatedly assessed over a year to determine if crisis intervention planning reduces their suicidal tendency compared to existing crisis management procedures.
- Project 4 will seek to understand for whom and under what circumstances specific stress management strategies are most effective in reducing suicidal tendencies. This project will recruit a national sample of members of suicide services who are not engaged in mental health treatment. All participants will collaboratively develop a crisis intervention plan with a trained researcher, then complete 28 consecutive days of assessment surveys via smartphone to assess real-time fluctuations in suicidal ideation and use of coping strategies. stress management and crisis intervention planning. This project will be led by Lauren Khazem and Heather Wastler, who are both assistant professors in the Ohio State Department of Psychiatry and Behavioral Health.
- Project 5 will test a brief intervention designed to improve the effectiveness of lethal means counseling on the safe storage of firearms among service members who possess firearms. Participants will receive a brief intervention to improve their ability to tolerate uncertainty as well as counseling on lethal means, with a 14-day period of smartphone surveys to assess real-time fluctuations in mood after each intervention. Researchers will assess safe firearm storage practices during follow-up. This project will be led by Nik Allan, assistant research professor in the Ohio State Department of Psychiatry and Behavioral Health.
“Our projects aim to help military clinicians make optimal treatment decisions for service members presenting with suicidal ideation and will help military leaders decide how best to prioritize and allocate resources around practical but potentially costs like treatment implementation efforts and training clinicians in effective suicide prevention strategies,” Bryan said.
This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs and the Defense Health Agency J9, Directorate of Research and Development, or the U.S. Army Medical Research Acquisition Activity at the U.S. Army Medical Research and Development Command, for $8,375,496 through the peer-reviewed medical research program under award number (W81XWH-22-2-0072). The opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.
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