Peer Mentorship to Reduce Suicide Attempts Among High-Risk Adults



Status:Enrolling by invitation
Conditions:Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:7/15/2018
Start Date:June 22, 2018
End Date:September 2021

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Effectiveness and Implementation of a Peer Mentorship Intervention (PREVAIL) to Reduce Suicide Attempts Among High-Risk Adults

Amid consistently worsening suicide rates, in 2012 the U.S.Surgeon General's National
Strategy for Suicide Prevention proposed to "change the narrative" about suicide prevention
to include a focus on promoting hope and belongingness. Despite hopelessness and thwarted
belongingness being among the most replicated risk factors for suicide, many widely
implemented suicide prevention efforts instead emphasize the identification of acute suicide
risk and referral to mental health treatment services. However, there are very few health
service interventions known to reduce suicides among those identified as high risk. Those
interventions shown to be effective have not achieved the wide scale implementation necessary
to alter the trend of increasing suicide deaths. New interventions are needed, and one
promising, scalable intervention with a novel approach to addressing the risk factors
advocated by the Surgeon General is peer mentorship. A peer mentorship intervention, PREVAIL,
has been piloted in a two-site randomized controlled trial (N=70) and is acceptable and
feasible with enrollment of nearly half of eligible high-risk patients, mean completion of
over 6 mentorship sessions, and 85% of sessions meeting fidelity standards for addressing the
intended targets of hope and belongingness.

The aims of this hybrid effectiveness-implementation study are:

Specific Aim 1: Determine the effectiveness of the PREVAIL peer mentorship intervention for
reducing suicide attempts and suicidal ideation among recently hospitalized adult psychiatric
patients at high risk for suicide.

Specific Aim 2: Examine the mechanisms of peer mentorship by measuring the effects of PREVAIL
on potential mediators,including hope and belongingness.

Specific Aim 3: Identify barriers and facilitators to implementation of PREVAIL.


Inclusion Criteria:

1. are age 18 years or older,

2. are currently admitted to an inpatient psychiatric unit and have medical record
documentation of suicidal ideation or suicide attempt at the time of admission,

3. have a Beck Suicide Scale score of 5 or higher for the 1-week period prior to
admission,

4. are fluent in English,

5. are able to be reached reliably by telephone.

Exclusion Criteria:

1. substantially cognitively impaired (according to the Mini-Cog),

2. unable to provide informed consent for any reason (including incompetency),

3. determined by the patient's attending psychiatrist that peer mentorship is not
appropriate due to unstable psychosis, cognitive disorder, or severe personality
disorder,

4. already receiving or intending to receive peer mentorship (i.e., sponsor from
Alcoholics Anonymous) or group-based peer support on a biweekly or more frequent
basis,

5. residing more than 50 miles from any peer mentor,

6. planning to be discharged to another inpatient or residential facility, or

7. receiving electroconvulsive therapy
We found this trial at
2
sites
10300 West 8 Mile Road
Ferndale, Michigan 48220
Principal Investigator: Brian Ahmedani, PhD
Phone: 734-845-3650
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Ferndale, MI
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Ann Arbor, Michigan 48109
Principal Investigator: Paul Pfeiffer, MD
Phone: 734-845-3650
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Ann Arbor, MI
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