Effect of crisis response planning on patient mood and clinician decision making: A clinical trial with suicidal U.S. soldiers
Open accessAbstract
OBJECTIVE: The study examined the immediate effect of crisis interventions on the emotional state of acutely suicidal soldiers and clinician decision making. METHODS: Soldiers (N=97) presenting to a military emergency department or behavioral health clinic were randomly assigned to receive a contract for safety (N=32), standard crisis response plan (S-CRP; N=32), or enhanced crisis response plan (E-CRP; N=33). Soldiers completed self-report scales before and after the intervention. Clinicians blinded to treatment group assignment rated participants' suicide risk level and made a decision about inpatient psychiatric admission. RESULTS: Larger reductions in negative emotional states occurred in S-CRP and E-CRP. Larger increases in positive emotional states occurred in E-CRP. Clinician suicide risk ratings did not differ across treatment groups. Participants in E-CRP were less likely to be psychiatrically admitted. CONCLUSIONS: The CRP immediately reduces negative emotional states among acutely suicidal soldiers. Discussing a patient's reasons for living during a CRP also reduces the likelihood of inpatient psychiatric admission.
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Our results are consistent with findings that crisis response planning reduced suicide attempts during a 6-month follow-up period in high-risk active duty soldiers.
“Our results are consistent with findings that crisis response planning reduced suicide attempts during a 6-month follow-up period in high-risk active duty soldiers.42”
From Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department (2018) · cites this paper as [42]
The Methods section reports that the parent trial found a significant reduction in suicide attempt rates among acutely suicidal active-duty Army personnel who received crisis response planning. The paper does not specify a six-month follow-up period for that finding; this paper itself examines immediate effects. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCrisis 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 [12]
Ketamine is just one potential rapid intervention; other rapid-acting interventions are likely associated with different patterns of symptom improvement.
“Finally, ketamine is just one potential rapid intervention for depression and suicidal thoughts; other rapid-acting interventions are likely associated with different patterns of symptom improvement (Bryan et al., 2018; Croarkin et al., 2018).”
From Clinical indicators of the suicide crisis and response to ketamine (2025) · cites this paper as Bryan et al., 2018
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- Authors
- Bryan, C. J., Mintz, J., Clemans, T. A., Burch, T. S., Leeson, B., Williams, S., & Rudd, M. D.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Psychiatric Services
- Published
- 2018-01-01
- Volume
- 69
- Issue
- 1
- Pages
- 108-111
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2763590286
- Cited by
- 63
- References
- 7
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 11 · 2023: 6 · 2022: 9 · 2021: 13 · 2020: 3 · 2019: 8 · 2018: 7
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense (W81XWH, W81XWH1020181)
- 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
- crisis response planning, suicide prevention, military personnel, clinician decision-making, suicide risk assessment, psychiatric hospital admissions, emotional state, reasons for living
- MeSH terms
- Clinical Decision-Making, Suicide Prevention, Adult, Crisis Intervention, Female, Humans, Male, Middle Aged, Military Personnel, Outcome and Process Assessment, Health Care, Patient Care Planning, Suicide, Attempted, Young Adult, Suicidal Ideation
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