First-Ever Randomized Clinical Trial Uses Telehealth for Suicide Prevention

Newswise — COLUMBUS, Ohio – Suicide remains a pressing public health concern. An estimated 703,000 people die by suicide each year worldwide, according to The World Health Organization. In 2022, there were 49,449 suicides in the United States.

 A new study found that brief cognitive behavioral therapy for suicide prevention – when delivered remotely via video telehealth – reduces suicide attempts and suicidal ideation.

Researchers at The Ohio State University Wexner Medical Center and College of Medicine led the study that is published online in the journal JAMA Network Open.

The randomized clinical trial of 96 U.S. adults with recent suicidal ideation and/or suicidal behavior found that mental health therapists can see high-risk suicidal patients virtually both safely and effectively.

Brief cognitive behavioral therapy is a treatment that has been shown to reduce suicide attempts by as much as 60% when compared to typical mental health care.

However, delivering this treatment remotely via video telehealth had never been tested. Until now.

The study was conducted between 2021 and 2023, during the height of the COVID-19 global pandemic.

“The impetus for this research question was the nearly overnight shift from mostly in-person to mostly virtual therapy appointments following the onset of the COVID-19 pandemic. Historically, high risk patients were considered inappropriate candidates for virtual healthcare, due to risk and liability concerns,” said principal investigator and Ohio State clinical psychologist Justin C. Baker, PhD.

“We wanted a way to ensure that those who needed care the most were able to receive care during the pandemic,” said Baker, who is the clinical director of Ohio State’s Suicide and Trauma Reduction Initiative (STRIVE) program.

Participants received one of these therapies:

• brief cognitive behavioral therapy, a suicide-focused treatment that teaches patients how to manage and change distressing emotions and negative thinking
• present-centered therapy, a goal-oriented treatment that helps participants identify adaptive responses to stressors

The study also showed that brief cognitive behavioral therapy led to significant reductions in suicide attempts when compared to present-centered therapy. Reductions in suicidal ideation occurred in both treatments.

Prior effectiveness trials have compared brief cognitive behavioral therapy to typical care, whereas this study compared it to another intervention that has been shown to reduce depression and suicidal thoughts, which is a higher comparison metric, Baker said.

This study provides critical insight into which kinds of treatments are most likely to lead to improved outcomes for those struggling with suicide. It also adds support to the effectiveness of this therapy for reducing suicidal behaviors.

“For those suffering with suicidal thoughts and behaviors, we have good, tested treatments that will lead to significant symptom reduction and improved quality of life,” said study co-investigator Craig Bryan, PsyD, professor in Ohio State’s Department of Psychiatry and Behavioral Health and director of its Suicide Prevention Program.

“Even with lessening restrictions, many therapists are keeping a portion of their telehealth practice post pandemic. This study has the potential to increase access to needed evidence-based treatments for those in rural and hard-to-reach areas,” said Bryan, who holds the Trott Gebhardt Philips endowed professorship.

Funding: Research reported in this publication was supported in part by a charitable gift from 33 Forever. The content is solely the responsibility of the authors and does not necessarily represent the official views of 33 Forever.

Conflict of Interest Disclosures: Justin Baker reported grants from the Department of Defense during the conduct of the study and personal fees from Anduril LLC outside the submitted work.

Craig Bryan reported grants from the Department of Defense, the National Institute of Mental Health, the New Jersey Gun Violence Research Center, and the American Foundation for Suicide Prevention during the conduct of the study and personal fees from Oui Therapeutics outside the submitted work.

AnnaBelle Bryan reported personal fees from Oui Therapeutics outside the submitted work.

Samantha Daruwala, PhD, reported a grant from the New Jersey Gun Violence Research Center during the conduct of the study.

Christina Rose Bauder, PhD, reported grants from the Department of Defense during the conduct of the study and personal fees from Anduril LLC outside the submitted work.

Lauren Khazem, PhD, reported a grant from the American Foundation for Suicide Prevention during the conduct of this study and personal fees from Anduril LLC outside the submitted work.

All other authors report no conflicts of interest.

If you or someone you know is struggling with thoughts of suicide, call or text the Suicide and Crisis Lifeline at 988. 

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