Use of crisis management interventions among suicidal patients: results of a randomized controlled trial
Open accessAbstract
BACKGROUND: Previous research supports the efficacy of the crisis response plan (CRP) for the reduction of suicidal behaviors as compared to treatment as usual (TAU). Patient perspectives and use of the CRP, and their relationship to later suicidal thoughts, remain unknown. METHODS: A secondary analysis of a randomized clinical trial comparing a standard CRP (S-CRP), a CRP enhanced with reasons for living (E-CRP), and TAU in a sample of 97 active-duty U.S. Army personnel was conducted. Participants were asked about their use, perceptions, and recall of each intervention. Generalized estimating equations were used to test the conditional effects of intervention use, perceptions, and recall on severity of suicide ideation during follow-up. RESULTS: Across all treatment groups, over 80% of participants retained their written CRP up to 6 months later, but less than 25% had the written plan in their physical possession at the time of each assessment. Participants in S-CRP and E-CRP were more likely to recall self-management strategies and sources of social support. Participants in TAU were more likely to recall use of professional healthcare services and crisis management services. All three interventions were rated as highly useful. More frequent use of the E-CRP and recall of its components were associated with significantly reduced suicide ideation as compared to TAU. CONCLUSIONS: Both CRPs have high acceptability ratings. The effect of both CRPs on reduced suicide ideation is associated with patient recall of components. More frequent use of the E-CRP is associated with larger reductions in suicide ideation.
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Crisis response or safety planning is associated with rapid changes in suicidal thoughts within hours and decreased risk of suicide attempt within months.
“Another new treatment approach is crisis response or safety planning, an outgrowth of cognitive behavioral therapy for suicide prevention that is associated with rapid changes in suicidal thoughts within hours (12) and decreased risk of suicide attempt within months (13, 14).”
From New methods for assessing rapid changes in suicide risk (2021) · cites this paper as [13]
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- Authors
- Bryan, C. J., May, A. M., Rozek, D. C., Williams, S. R., Clemans, T. A., Mintz, J., Leeson, B., & Burch, T. S.
- Affiliations
- University of Utah (US)
- The University of Texas at San Antonio Health Science Center (US)
- United States Department of the Army (US)
- Corresponding author
- Bryan, Craig J.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2018-05-10
- Volume
- 35
- Issue
- 7
- Pages
- 619-628
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2800263609
- Cited by
- 43
- References
- 33
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 10 · 2020: 3 · 2019: 6
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research and Materiel Command (W81XWH‐10‐2‐0181)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- suicide prevention, suicidal ideation, reasons for living, intervention use, treatment acceptability, active duty military personnel, self-management strategies, social support
- MeSH terms
- Self-Management, Suicide Prevention, Adult, Female, Humans, Male, Military Personnel, Patient Acceptance of Health Care, United States, Young Adult, Suicidal Ideation
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