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Text message-based intervention shows promise for suicide prevention

Augmenting standard care with a text message-based intervention, known as Caring Contacts, did not decrease current suicidal ideation or suicide risk events at 12-month follow-up among active-duty military personnel in a randomized clinical trial.

However, the intervention did reduce the odds of having any suicidal ideation and making a suicide attempt between baseline and follow-up, according to the results.

In prior randomized clinical trials, Caring Contacts, which provides periodic messages expressing care and concern, has been shown to prevent suicide, Katherine Anne Comtois, PhD, MPH, from the department of psychiatry & behavioral sciences, University of Washington School of Medicine, and colleagues wrote in JAMA Psychiatry.

“Pilot research on Caring Contacts via text message showed high feasibility and acceptability, but to our knowledge, this had not been rigorously evaluated in a clinical trial,” they wrote.

Comtois and colleagues evaluated the effectiveness of supplementing standard military health care with Caring Contacts delivered via text message to decrease suicidal thoughts and behaviors over a 1-year period in a trial conducted at three U.S. military installations.

Soldiers and Marines at risk for suicide received standard care, and the Caring Contacts group also received 11 text messages (delivered on day 1, at week 1, at months 1 to 4, every other month until month 12 and on participants’ birthdays). The researchers measured current suicidal ideation and suicide risk incidents (primary outcomes), as well as worst-point suicidal ideation, ED visits and suicide attempts (secondary outcomes).

All 657 participants reported suicidal ideation at baseline, 461 were assessed at 12 months and 291 reported previously attempting suicide.

Comtois and colleagues found nonsignificant results for primary outcomes, with no significant effect on likelihood or severity of current suicidal ideation or likelihood of a suicide risk incident. In addition, the intervention did not decrease the number of ED visits.

However, participants who received the intervention had lower odds of experiencing suicidal ideation between baseline and follow-up than those receiving standard care alone (OR = 0.56; 95% CI, 0.33-0.95). In addition, fewer participants receiving Caring Contacts had attempted suicide since baseline than the standard care only group (9% vs. 14.9%; OR = 0.52; 95% CI, 0.29-0.92).

“These outcomes support the effectiveness of Caring Contacts and provide the military with a practical and scalable tool to reduce suicide risk,” Comtois and colleagues wrote. “A crucial next step for research is to empirically evaluate and understand the mechanism by which Caring Contacts have their effect.” – by Savannah Demko

Disclosure: Comtois reports research funding from the Military Suicide Research Consortium. Please see the study for all other authors’ relevant financial disclosures.