Engaging Suicidal Patients in Mental Health Treatment

NCT05021224 | Completed Results DMC

• 2 other identifiers: 8295385R21MH123851
• Study Type: interventional
• Target: 29
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators will identify characteristics of suicidal patients who do or do not attend a first mental health visit following referral using administrative data. Then, the investigators will apply established approaches to contextual inquiry to identify barriers and facilitators to mental health treatment attendance for individuals at risk of suicide. Using established procedures from implementation science and behavioral economics, the investigators will then leverage the insights gleaned from Aims 1 and 2, relevant theories and frameworks, and the extant literature to develop preliminary strategies to support attendance at first mental health visit. Strategies will be developed in collaboration with a team of experts in suicide, implementation science, and behavioral economics. These preliminary strategies will then be iteratively tested and refined. The investigators also will assess putative mechanism using behavioral tasks and self-report tools.

Conditions

Suicide; Depression; Mental Health Impairment; Suicidal Ideation; Suicidal

Outcome Measures

Primary Outcomes (4)

• Acceptability of Intervention Measure (AIM)

  A reliable and valid 4-item tool to assess perceptions of the acceptability of engagement strategies. Each item is rated using a 5-point ordinal response options, ranging from 1= "completely disagree" to 5="completely agree" and scores are averaged across the four items to yield a mean scale score. Higher scores indicate greater acceptability.

  6 months

• Intervention Appropriateness Measure (IAM)

  A reliable and valid 4-item tool to assess perceptions of the appropriateness of engagement strategies to the context. Each item is rated using a 5-point ordinal response options, ranging from 1= "completely disagree" to 5="completely agree" and scores are averaged across the four items to yield a mean scale score. Higher scores indicate greater appropriateness.

  6 months

• Feasibility of Intervention Measure (FIM)

  A reliable and valid 4-item tool to assess perceptions of the feasibility of engagement strategies. Each item is rated using a 5-point ordinal response options, ranging from 1= "completely disagree" to 5="completely agree" and scores are averaged across the four items to yield a mean scale score. Higher scores indicate greater feasibility.

  6 months

• Attendance at First Mental Health Visit

  Derived from the electronic health record, defined as patient did or did not attend first mental health visit following referral.

  6 months

Study Arms (4)

Caring Contacts

ACTIVE COMPARATOR

Non-demanding message sent from the care team

Behavioral: Caring Contacts

Reminders

ACTIVE COMPARATOR

Appointment reminders sent electronically

Behavioral: Reminders

Informational Poster

ACTIVE COMPARATOR

An informational poster linking to an infographic

Behavioral: Informational Poster

Motivational Interviewing

ACTIVE COMPARATOR

Motivational interviewing training for intake coordinators

Behavioral: Motivational Interviewing

Interventions

Caring Contacts BEHAVIORAL

Non-demanding message sent from the care team

Caring Contacts

Reminders BEHAVIORAL

Appointment reminders sent electronically

Reminders

Informational Poster BEHAVIORAL

An informational poster linking to an infographic

Informational Poster

Motivational Interviewing BEHAVIORAL

Motivational interviewing training for intake coordinators

Motivational Interviewing

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years and older
• Elevated suicidal ideation per item 9 of the Patient Health Questionnaire (PHQ item score ≥ 1) completed during a primary care visit
• Able to read and understand English

You may not qualify if:

• Current psychotic episode requiring emergency services and/or precluding ability to provide informed consent
• Documented diagnosis of dementia in the past 2 years. The rationale for this criteria is that these individuals may have difficulty understanding the study information provided to them, including how to opt out of the study
• No patients will be excluded on the basis of sex, race, or ethnicity
• Primary care provider notes that participation is not indicated
• Already received a study engagement strategy following a different primary care visit.

Sponsors & Collaborators

• University of Pennsylvania: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (2)

• Wolk CB, Pieri M, Weiss SE, Harrison J, Khazanov GK, Candon M, Oslin DW, Press MJ, Anderson E, Famiglio E, Buttenheim A, Jager-Hyman S. Engaging primary care patients at risk for suicide in mental health treatment: user insights to inform implementation strategy design. BMC Prim Care. 2024 Oct 16;25(1):371. doi: 10.1186/s12875-024-02616-w.

  PMID: 39415093 DERIVED

• Khazanov GK, Jager-Hyman S, Harrison J, Candon M, Buttenheim A, Pieri MF, Oslin DW, Wolk CB. Leveraging behavioral economics and implementation science to engage patients at risk for suicide in mental health treatment: a pilot study protocol. Pilot Feasibility Stud. 2022 Aug 13;8(1):181. doi: 10.1186/s40814-022-01131-y.

  PMID: 35964151 DERIVED

MeSH Terms

Conditions

Suicide; Depression; Suicidal Ideation

Interventions

Motivational Interviewing

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Directive Counseling; Counseling; Mental Health Services; Behavioral Disciplines and Activities; Health Services; Health Care Facilities Workforce and Services

Results Point of Contact

• Title: Dr. Courtney Wolk
• Organization: University of Pennsylvania

courtney.wolk@pennmedicine.upenn.edu

215-746-6099

Study Officials

• Courtney Benjamin Wolk, PhD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

• Shari Jager-Hyman, PhD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 26, 2021
• First Posted: August 25, 2021
• Study Start: March 7, 2022
• Primary Completion: January 12, 2024
• Study Completion: January 12, 2024
• Last Updated: June 8, 2025
• Results First Posted: June 8, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)