The first-ever randomized clinical trial uses video telehealth for suicide prevention

Suicide remains an urgent public health problem. According to the World Health Organization, an estimated 703,000 people worldwide die by suicide every year. In 2022, there were 49,449 suicides in the United States.

A new study has found that brief cognitive behavioral therapy for suicide prevention – when delivered remotely via video telehealth – reduces suicide attempts and thoughts. Researchers from The Ohio State University Wexner Medical Center and College of Medicine led the study, which is published online in the journal JAMA network opened.

The randomized clinical trial of 96 U.S. adults with recent suicidal ideation and/or suicidal behavior found that mental health therapists can treat high-risk suicidal patients nearly both safely and effectively.

Brief cognitive behavioral therapy is a treatment that has been shown to reduce suicide attempts by as much as 60% compared to regular mental health care.

However, delivering this treatment remotely via video telehealth had never been tested until now.

The survey was conducted between 2021 and 2023, during the height of the global COVID-19 pandemic.

“The impetus for this research question was the almost overnight shift from primarily in-person to primarily virtual therapy appointments following the onset of the COVID-19 pandemic. Historically, high-risk patients have been considered unsuitable candidates for virtual healthcare due to hazards and hazards. concerns about liability,” said lead researcher and Ohio State clinical psychologist Justin C. Baker, Ph.D.

“We wanted a way to ensure that those who needed care most were able to receive care during the pandemic,” said Baker, clinical director of Ohio State's Suicide and Trauma Reduction Initiative (STRIVE) program.

Participants received one of these therapies:

• Brief cognitive behavioral therapy, a suicide-focused treatment that teaches patients how to manage and change painful emotions and negative thinking
• Present-centered therapy, a goal-oriented treatment that helps participants identify adaptive responses to stressors

The study also showed that brief cognitive behavioral therapy led to a significant reduction in suicide attempts compared to present-focused therapy. A reduction in suicidal thoughts occurred with both treatments.

Previous effectiveness studies have compared brief cognitive behavioral therapy with typical care, while this study compared it with another intervention shown to reduce depression and suicidal ideation, which is a higher benchmark for comparison, Baker said.

This study provides critical insight into which types of treatments are most likely to lead to better outcomes for people struggling with suicide. It also adds support to the effectiveness of this therapy for reducing suicidal behavior.

“For those suffering from suicidal thoughts and behaviors, we have good, proven treatments that will lead to significant reductions in symptoms and improved quality of life,” said co-researcher Craig Bryan, PsyD, professor in the Department of Psychiatry and Ohio State Behavioral Health. and director of the suicide prevention program.

“Even with waning restrictions, many therapists are maintaining some portion of their telehealth practice post-pandemic. This study has the potential to increase access to necessary, evidence-based treatments for people in rural and hard-to-reach areas,” said Bryan, who holds the Trott Gebhardt Philips Endowed Professorship.