Peer-written caring letters for veterans after a suicidal crisis

Objective In the evidence-based suicide prevention intervention, Caring Letters, healthcare providers send brief, caring messages to patients following psychiatric inpatient care, a time of elevated suicide risk. However, recent studies with military populations have found mixed results. An adaptation of Caring Letters employed a peer framework in which veterans from the community wrote brief caring […]

Comparative effectiveness of safety planning intervention with instrumental support calls (ISC) versus safety planning intervention with two-way text message caring contacts (CC) in adolescents and adults screening positive for suicide risk in emergency departments and primary care clinics: Protocol for a pragmatic randomized controlled trial

Background: Suicide is a leading cause of death in adolescents and adults in the US. Follow-up support delivered when patients return home after an emergency department (ED) or primary care encounter can significantly reduce suicidal ideation and attempts. Two follow-up models to augment usual care including the Safety Planning Intervention have high efficacy: Instrumental Support Calls […]

Analysis of reported suicide safety events among veterans who received treatment through Department of Veterans Affairs–contracted community care

Introduction Veteran patients have access to a broad range of health care services in the Veterans’ Health Administration (VHA). There are concerns, however, that all Veteran patients may not have access to timely care. The Maintaining Internal Systems and Strengthening Integrated Outside Networks Act was passed in 2018 to ensure that eligible Veterans can receive […]

Identifying opportunities for informatics-supported suicide prevention: The case of Caring Contacts

Suicide is the tenth leading cause of death in the United States. Caring Contacts (CC) is a suicide prevention intervention involving care teams sending brief messages expressing unconditional care to patients at risk of suicide. Despite solid evidence for its effectiveness, CC has not been broadly adopted by healthcare organizations. Technology has the potential to […]

Can postdischarge follow-up contacts prevent suicide and suicidal behavior? A review of the evidence

Background: The time period following discharge from inpatient psychiatry and emergency department (ED) treatment is one of heightened risk for repeat suicide attempts for patients. Evidence reported in the literature shows that follow-up contacts might reduce suicide risk, although there has not been a comprehensive and critical review of the evidence to date. Aims: To evaluate evidence […]

Caring letters project: A military suicide-prevention pilot program

Background: The Caring Letters Project (CLP) is a suicide prevention program that involves sending brief caring letters to discharged inpatients following psychiatric hospitalization. Several studies suggest that repeatedly sending caring messages may reduce suicides and suicide attempts in high-risk populations. Aims: The aims of this study were to (1) evaluate feasibility of use in the military setting, […]

Caring e-mails for military and veteran suicide prevention: A randomized controlled trial

Objective The purpose of this multisite study was to conduct a randomized controlled trial of an e-mail version of the caring letters (CL) suicide prevention intervention to determine whether the intervention is efficacious in preventing suicide behaviors among U.S. service members and veterans. Method Psychiatric inpatients (N = 1,318) were recruited from four military medical centers and […]

Designed and created for a veteran by a veteran: A pilot study of caring cards for suicide prevention

Introduction This pilot study investigates feasibility and acceptability of Caring Cards, a suicide prevention intervention inspired by Caring Contacts and the Recovery Model, where Veteran peers create cards that are sent to Veterans recently discharged from a VA psychiatric hospitalization for suicide risk. Methods Caring Cards consists of: (1) a weekly outpatient group where Veterans […]

Third-party callers to the national suicide prevention lifeline: Seeking assistance on behalf of people at imminent risk of suicide

Objective To assist suicidal individuals, people in their social network are often directed to the National Suicide Prevention Lifeline (Lifeline). The study’s objective was to provide information on third-party calls made out of concern for another person. Method Reports on 172 third-party calls concerning individuals deemed to be at imminent suicide risk were completed by […]

A peer approach to suicide prevention and recovery: Study protocol for a feasibility and acceptability trial of Caring Cards for veterans

Introduction There is a need to develop, evaluate, and implement interventions that reduce Veteran suicide. Caring Cards (CC) is a novel intervention that integrates aspects of caring contacts and peers (i.e., persons with lived mental health experience). In CC, Veterans meet in a weekly group to create hope-filled cards that are sent to Veterans with […]

Caring contacts for suicide prevention: A systematic review and meta-analysis

Caring Contacts (CC), a low-cost intervention originally designed and tested by Jerome Motto in 1976, remains one of the few strategies to demonstrate efficacy in the prevention of suicide deaths. Interest in CC has increased steadily over the last several years in tandem with rising U.S. suicide rates and the acceleration of suicide prevention initiatives. […]

Implementation strategy to increase clinicians’ use of the caring letters suicide prevention intervention

Caring Letters is recommended in multiple best practice guidelines; however, the Caring Letters intervention has not been widely implemented. The process of tracking, scheduling, and mailing letters for multiple patients over many months may represent a significant barrier for busy clinicians. This evaluation examined whether the use of centralized administrative support (Centralized Caring Letters; CCL) […]

Adapting caring contacts for veterans in a Department of Veterans Affairs emergency department: Results from a type 2 hybrid effectiveness-implementation pilot study

Transitions in care, such as discharge from an emergency department (ED), are periods of increased risk for suicide and effective interventions that target these periods are needed. Caring Contacts is an evidence-based suicide prevention intervention that targets transitions, yet it has not been widely implemented. This pilot study adapted Caring Contacts for a Department of […]