Research from the University of Utah psychology department discovered a simpler and more efficient way to prevent suicide attempts from veterans and Post-Traumatic Stress Disorder patients.
In the study “Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers,” Dr. Craig J. Bryan, Jim Mintz, Dr. Tracy A. Clemans and others found that crisis response planning, a form of planned intervention, can significantly reduce suicide attempts among those suffering from PTSD.
Crisis response planning (CRP) is a method used to predict and prevent suicidal behavior by “identifying one’s personal warning signs, using coping strategies, activating social support and accessing professional services,” according to the study.
The alternative method which is a contract for safety, requires veterans to sign a form in which they agree “that [they] will not harm [themselves] in any way, attempt suicide, or die by suicide.”
The study found that of the two methods, CRP was “associated with significantly faster decline in suicide ideation” and found to be more effective than contracts for safety.
Out of a sample of 97 participants, five of those who received contracts for safety, attempted suicide compared to only three who received CRP. This, the authors say, suggests a “76 [percent] reduction in suicide attempts.”
Contracts for safety are less effective than CRP because they are not dynamic or interactive, according to Bryan, an associate professor in the U’s Department of Psychology, as well as the Executive Director of the National Center for Veterans Studies.
“The biggest flaw is the absence of an actual intervention,” Bryan said. “In the contract for safety, the suicidal individual is asked to make a commitment to not engage in suicidal behavior, but they aren’t given any instruction about how to do this. As a result, they are essentially asked to not do something without being told how to do [it].”
Crisis response planning, on the other hand, is more individualized: “It isn’t a ‘one size fits all’ approach,” said Bryan.
People who suffer from post-traumatic stress can benefit from CRP because it is a “simple and straightforward strategy that is customized to their needs,” Bryan said. “That seems to be why it’s so useful: it is personally tailored to each individual person.”
Crisis response planning is “not widely” used by clinicians and practitioners, Bryan said. Even when it is used, it is often done so incorrectly. To address this, Bryan suggests “working on conducting trainings to make sure clinicians really know how to do this intervention well.”
Research has consistently shown that those suffering from PTSD are an at-risk population for attempting or committing suicide. There are an estimated 5.2 million people in the U.S. who are diagnosed with PTSD. Of those, hundreds of thousands are veterans.
A limitation of the study is that it looked at a small sample size that could be non-representative of larger populations.
“This study is only the first step,” Bryan said. “We’ll continue to research the crisis response plan to see if it works with different groups of people, and to see if we can make it work even better.”
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