Caring letters for suicide prevention: implementation of a multi-site randomized clinical trial in the U.S. military and Veteran Affairs healthcare systems

Luxton, David D.; Thomas, Elissa K.; Chipps, Joan; Relova, Rona M.; Brown, Daphne; McLay, Robert; Lee, Tina T.; Nakama, Helenna; Smolenski, Derek J.

doi:10.1016/j.cct.2014.01.007

Cited by 52Suicide and Self-Harm StudiesHealth Policy Implementation SciencePsychiatric care and mental health services

Caring letters for suicide prevention: implementation of a multi-site randomized clinical trial in the U.S. military and Veteran Affairs healthcare systems

Luxton, David D., Thomas, Elissa K., Chipps, Joan, Relova, Rona M., Brown, Daphne, McLay, Robert, Lee, Tina T., Nakama, Helenna +1 more·2014·Contemporary Clinical Trials

DOI 10.1016/j.cct.2014.01.007

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Abstract

Caring letters is a suicide prevention intervention that entails the sending of brief messages that espouse caring concern to patients following discharge from treatment. First tested more than four decades ago, this intervention is one of the only interventions shown in a randomized controlled trial to reduce suicide mortality rates. Due to elevated suicide risk among patients following psychiatric hospitalization and the steady increase in suicide rates among the U.S. military personnel, it is imperative to test interventions that may help prevent suicide among high-risk military personnel and veterans. This paper describes the design, methods, study protocol, and regulatory implementation processes for a multi-site randomized controlled trial that aims to evaluate the effectiveness of a caring emails intervention for suicide prevention in the military and VA healthcare systems. The primary outcome is suicide mortality rates to be determined 24 months post-discharge from index hospital stay. Healthcare re-utilization rates will also be evaluated and comprehensive data will be collected regarding suicide risk factors. Recommendations for navigating the military and VA research regulatory processes and implementing a multi-site clinical trial at military and VA hospitals are discussed.

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Review: Facilitators and barriers to implementation of suicide prevention interventions: Scoping review — R0/PR3
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Development of the Veterans Crisis Line Caring Letters Suicide Prevention Intervention
Reger, M. A., Lauver, M., Manchester, C., Abraham, T. H., Landes, S. J., Garrido, M. M., Griffin, C., Woods, J. A., Strombotne, K. L., & Hughes, G. (2022) · Health Services Research · doi:10.1111/1475-6773.13985 · Cited by 16 · see citing works

Authors: Luxton, D. D., Thomas, E. K., Chipps, J., Relova, R. M., Brown, D., McLay, R., Lee, T. T., Nakama, H., & Smolenski, D. J.
Affiliations: University of Washington (US)
VA Western New York Healthcare System (US)
Stanford University (US)
Landstuhl Regional Medical Center (DE)
Naval Medical Center San Diego (US)
Tripler Army Medical Center (US)
Corresponding author: Luxton, David D.
ORCID: Luxton, David D.
Smolenski, Derek J.
Venue: Contemporary Clinical Trials
Publisher: Elsevier BV
Published: 2014-03
Volume: 37
Issue: 2
Pages: 252-260
ISSN: 1551-7144 (ISSN-L)
DOI: 10.1016/j.cct.2014.01.007
OpenAlex: W1979105103
Cited by: 52
References: 31
Citations by year: 2026: 2 · 2025: 2 · 2024: 1 · 2023: 11 · 2022: 7 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 2
FWCI: 4.72
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Contemporary Clinical Trials (publishedVersion)
PubMed (publishedVersion)
Funders: Department of the Army (W81XWH-11-2-0123)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: suicide prevention, suicide mortality, military personnel, veterans, psychiatric hospitalization, post-discharge follow-up, email intervention, suicide risk factors, Department of Veterans Affairs
MeSH terms: Suicide Prevention, Empathy, Health Status, Humans, Mental Health, Military Personnel, Patient Discharge, Psychiatric Department, Hospital, Research Design, Risk Factors, Socioeconomic Factors, Suicide, Attempted, United States, Veterans, Electronic Mail

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Caring letters for suicide prevention: implementation of a multi-site randomized clinical trial in the U.S. military and Veteran Affairs healthcare systems

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