The purpose of this project is to conduct a randomized controlled trial (RCT) with psychiatrically hospitalized Veterans who are at high-risk for suicide. Participants will be recruited from the Acute Psychiatric Inpatient Unit at the Syracuse VAMC. To meet high-risk criteria, Veterans must score over two on the Beck Scale for Suicidal Ideation (SSI), which is prospectively predictive of death by suicide. After providing informed consent, participants will complete a screening assessment to confirm eligibility and a baseline assessment of risk- factors for suicide. Participants will then be randomized to receive Motivational Interviewing to Address Suicidal Ideation (MI-SI) plus treatment as usual (TAU), or TAU alone. The MI-SI group will receive two sessions of MI- SI during hospitalization and one MI-SI telephone booster sessions after discharge. Participants in both conditions will be asked to complete telephone follow-up interviews at one, three, and six months after discharge. The primary outcome will be change in the severity of suicidal ideation as measured by the SSI. Exploratory analyses will examine the impact of MI-SI on treatment engagement, and treatment engagement as a partial mediator of the impact of MI-SI on the severity of suicidal ideation.
Veterans who receive health care from the VA are at elevated risk for suicide, and the number of Veterans at high risk may be growing. Although the months following discharge from psychiatric hospitalization are a period of acute risk for Veterans, there is a dearth of empirically supported treatments tailored to psychiatric inpatients and no studies examining treatments for psychiatrically hospitalized Veterans. The purpose of this RCT is to test the efficacy of an adaptation of Motivational Interviewing to Address Suicidal Ideation (MI-SI) on the severity of suicidal ideation in psychiatrically hospitalized Veterans at high risk for suicide. Findings will set the stage for an RCT examining the efficacy of MI-SI on risk for suicidal behavior in Veterans, research examining mechanisms by which MI-SI may work, and ultimately contribute to the implementation of effective preventive interventions for high-risk Veterans across VA.
