Service-Ready Tools for Identification, Prevention, and Treatment of Suicide Risk

Presenter:

Joel Sherrill, Ph.D.
Division of Services and Intervention Research

Goal:

This initiative is intended to support the development and testing of optimized, service-ready tools to enhance suicide prevention by improving the identification and treatment of individuals at risk for suicide. Evidence-based approaches exist for reducing suicidal ideation, suicide attempts, and death by suicide. However, there is a crucial need for scalable, practice-ready versions of these research-supported strategies to enhance uptake, effective delivery, and sustained use of these approaches. This initiative encourages research on the effectiveness-implementation continuum aimed at (1) developing and testing the effectiveness of service-ready suicide prevention tools and (2) testing strategies to improve adoption, implementation fidelity, and sustained use of these tools, within an implementation science framework.

Rationale:

Consistent with the goals of the National Action Alliance for Suicide Prevention, NIMH seeks to support research on strategies that could be used to reduce the rate of suicide in the U.S. by 20% by 2025. To realize this goal, effective suicide prevention strategies must be brought to scale at a level not seen before. To bridge the well-documented research-to-practice gap and aid in the systematic implementation of evidenced-based suicide prevention services, NIMH seeks research on service-ready tools for identification, prevention, and treatment of individuals at risk for suicide.

Suicide prevention within healthcare systems requires a multi-faceted approach. For example, delivery-oriented tools could enhance administration and precision of screening, while clinical decision-support tools for risk stratification could facilitate efforts to match individuals to the appropriate intensity of services. Tools that incorporate predictive analytics, practice alerts, and clinical dashboards at a systems-level could reduce provider burden, facilitate surveillance, and improve detection of at-risk individuals.

One area in dire need of action is the development of tools to ensure that empirically supported brief interventions (e.g., safety planning) and psychosocial interventions are delivered with fidelity. Furthermore, issues of resource allocation and barriers to in-person and mobile health treatment (e.g., rurality, poverty, stigma) demand adaptation of standard protocols. Hence, there is a need for technology-assisted strategies and other scalable approaches (e.g., sustainable models for expert telephone consultation) that can be used to train providers to initial competence, to monitor quality, and to promote sustained fidelity in the delivery of research-supported suicide prevention services across a range of clinical modalities, including telehealth.

Given the focus on practice-ready accessible resources that could be readily integrated into practice with minimal reconfiguration or adjustment, NIMH encourages the use of technology and other design features that make the resultant tools scalable and robust against implementation drift, and expects applicants to utilize a deployment-focused approach that proactively considers workforce capacity and system-level factors that influence potential integration of tools into clinical workflows.