Facilitating use of the National Suicide Prevention Lifeline in Alcohol Patients

促进酒精患者使用国家自杀预防生命线

• 批准号: 10228104
• 负责人: MARK A. ILGEN
• 金额: $ 66.9万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228104
• 关键词: Acute; Address; Adult; Aftercare; Aggressive behavior; Alcohol consumption; Alcohols; Attention; Attitude; Behavior; Behavior Control; Behavioral; Belief; Caring; Cessation of life; Characteristics; Clinical; Data; Diagnosis; Elements; Feeling suicidal; Future; General Population; Homicide; Hour; Impulsive Behavior; Impulsivity; Individual; Intervention; Lead; Life; Light; Link; Logistics; Mediating; Modeling; Outcome; Participant; Patients; Pharmacotherapy; Planning Theory; Population; Procedures; Publishing; Randomized; Randomized Controlled Trials; Reporting; Resources; Risk; Risk Factors; Sampling; Savings; Substance Use Disorder; Suicide; Suicide attempt; Suicide prevention; Testing; Time; United States; United States Substance Abuse and Mental Health Services Administration; alcohol abuse therapy; alcohol use disorder; base; behavior change; brief intervention; efficacy testing; experience; follow-up; high risk; high risk population; ideation; improved; novel; post intervention; preventive intervention; primary outcome; recruit; reducing suicide; service delivery; suicidal; suicidal behavior; suicidal morbidity; suicidal risk; suicide mortality; suicide rate; therapy design; tool; treatment as usual

ABSTRACT Individuals with Alcohol Use Disorders (AUDs) are at significantly elevated risk for fatal and non-fatal suicide attempts. This is seen in higher rates of suicide mortality in those diagnosed with an AUD as well as the high rates of prior suicidal behaviors and/or current suicidal ideation among of patients treated for AUDs. This elevated risk persists following AUD treatment. In addition, those with AUDs are prone to impulsive suicide attempts, those attempts that occur with less than 30 minutes planning, and can lead to rapid escalation in risk, particularly when under the influence of alcohol. New and effective strategies are needed to reduce suicide risk among those with AUDs and should be tailored to the unique risks in those with AUDs. The National Suicide Prevention Lifeline (NSP Lifeline) was established by Substance Abuse and Mental Health Services Administration (SAMHSA) to increase consistency in delivery of services. SAMHSA also implemented follow up procedures with treatment referrals for NSP Lifeline callers. Since its inception, the NSP Lifeline has received > 5 million calls. However, no data are currently available on whether use of the NSP Lifeline reduces an individual's likelihood of a suicide attempt or death and it is not feasible to test the efficacy of the Crisis Line in a randomized controlled trial because it is already nationally available. Additionally, the NSP Lifeline may not reach those individuals at most acute risk for suicide. Consequently, we developed and gathered pilot data on a brief intervention designed to increase utilization of crisis lines among high risk patients, called Crisis Line Facilitation (CLF). This single-session intervention involves a discussion of the patient's perceived barriers and facilitators of crisis line use during periods of suicidal crisis. The CLF session ends with the patient calling the NSP Lifeline with the therapist in the room as a way for them to practice the logistics of making the call and to have direct experiences that may counter any negative beliefs about crisis line use. The proposed study will recruit 500 participants who are currently receiving residential AUD treatment and have made a prior suicide attempt. This study will be a randomized controlled trial of the impact of CLF compared to enhanced usual care (EUC) on utilization of the NSP Lifeline as well as suicide attempt(s). All participants will be re-assessed at post-intervention, 4-, 8- and 12-months post baseline. Analyses will also examine the extent to which lifetime changes in the proposed mechanisms of action of CLF explain the effects of CLF on calls to the NSP Lifeline and suicide attempts as we as whether post-baseline NSP Lifeline use mediates the effect or random assignment to CLF on subsequent suicidal behaviors. If successful, the proposed study will provide key data on the potential efficacy of a brief tool to improve the utilization of an existing resource, the NSP Lifeline, to reduce suicidal behaviors in adults receiving treatment for AUDs. Developing a brief and effective approach to encourage use of NSP Lifeline has the potential to have a substantial impact on suicide rates and could be modified and exported to other populations and settings.

抽象的 患有饮酒障碍的人（AUD）的致命和非致命自杀风险显着升高 尝试。这在诊断为AUD和高的人中的自杀死亡率较高时可以看出 在接受AUDS治疗的患者中，先前的自杀行为和/或当前自杀念头的率。这 AUD治疗后，风险持续升高。此外，那些有声音的人容易自杀 尝试，这些尝试在不到30分钟的计划中发生的尝试，并可能导致风险迅速升级， 特别是在酒精的影响下。需要新的有效策略来降低自杀风险 在有澳元的人中，应根据有声音的人的独特风险进行量身定制。民族自杀 预防生命线（NSP生命线）是通过药物滥用和心理健康服务建立的 管理（SAMHSA）以增加服务交付的一致性。 SAMHSA还实施了 使用NSP生命线呼叫者进行治疗转介的程序。自成立以来，NSP生命线具有 接到> 500万个电话。但是，目前尚无有关使用NSP生命线是否减少的数据 一个人自杀未遂或死亡的可能性，测试危机线的功效是不可行的 在一项随机对照试验中，因为它已经在全国范围内可用。此外，NSP生命线可能不会 以自杀的最大风险与那些人联系。因此，我们制定并收集了有关的试验数据 一项简短的干预措施，旨在增加高风险患者中危机线的利用，称为危机线 促进（CLF）。这种单会干预涉及讨论患者的感知障碍和 自杀危机期间危机线使用的促进者。 CLF会议以患者打电话结束 NSP的救生层与房间中的治疗师一起，是他们练习呼叫和进行的后勤工作的一种方式 有直接的经验可以抵消对危机线路使用的任何负面信念。拟议的研究将 招募500名参与者，他们目前正在接受住宅AUD治疗，并已自杀 试图。这项研究将是对CLF影响的随机对照试验，与增强的常规护理相比 （EUC）在使用NSP生命线以及自杀企图方面。所有参与者将在 干预后，基线后4-，8和12个月。分析还将检查寿命的程度 提议的CLF作用机制的变化解释了CLF对NSP命令的影响 自杀的尝试是在基线后NSP生命线使用是否会介导效果或随机的效果 在随后的自杀行为上分配给CLF。如果成功，拟议的研究将提供关键数据 关于改善现有资源NSP生命线利用的简短工具的潜在功效 减少接受AUD治疗的成年人的自杀行为。开发一种简短有效的方法 鼓励使用NSP生命线有可能对自杀率产生重大影响，并且可能是 修改并导出到其他人群和设置。