DR. MARJAN HOLLOWAY: SUICIDE CARE, PREVENTION, AND RESEARCH (CPR) INITIATIVE
The Suicide CPR Initiative, previously known as the Laboratory for the Treatment of Suicide-Related Ideation and Behavior, was established in 2006. Dr. Holloway, the Director of the Suicide CPR Initiative, is a clinical psychologist and an intervention scientist who is primarily interested in developing and empirically evaluating novel interventions for suicide risk reduction. The Suicide CPR Initiative is strategically in a unique position to focus on the problem of military suicide, given its origins at USU and its established partnerships with the Department of Defense and Veterans Affairs, as well as national and international collaborators and stakeholders. Overall, the mission of the Suicide CPR Initiative is threefold:
- CARE: To develop effective interventions targeted at reducing suicidal thoughts and/or behaviors
- PREVENTION: To save lives through education, intervention, science, and advocacy
- RESEARCH: To advance suicide intervention science and practice
THE HUMAN FACTORS & MEDICINE RESEARCH TASK GROUP
The Human Factors & Medicine (HFM), Research Task Group (RTG) 218 Technical Report underscores that military suicide prevention must be recognized globally as a top-priority public health issue. This multinational collaboration is an important first step towards promoting a global public health strategy for combating military suicide. The RTG-218 involved the creation of new knowledge based on strong scientific methodology. A questionnaire was designed by the members and submitted to the NATO leadership for dissemination to each nation’s Surgeon General or other suitable representative. The NATO leadership invited at least 34 NATO and partner nations for participation in this project. Overall, a total of 14 NATO, 2 Euro-Atlantic Partnership Council, and one Partner across the globe participated in this international effort to systematically collect information on military suicide. A new task group, HFM-RTG-277 (Leadership Tools for Suicide Prevention), has been formed to continue this international effort.
POST ADMISSION COGNITIVE THERAPY: A BRIEF INTERVENTION FOR PSYCHIATRIC INPATIENTS FOLLOWING A SUICIDE RELATED EVENT
To date, there are no evidence-based civilian or military inpatient interventions aimed at the reduction of suicide behavior. We have addressed this important research and practice gap by designing and evaluating an innovative cognitive behavioral intervention program, Post Admission Cognitive Therapy (PACT). The broad objective of this study is to empirically evaluate the efficacy of PACT for military service members and beneficiaries admitted for inpatient care due to severe suicide ideation and/or a recent suicide attempt.
PACT involves (1) building a therapeutic alliance and developing a cognitive behavioral conceptualization based on the recent suicidal crisis; (2) instilling hope, practicing effective coping strategies, and addressing problem-solving deficits; and (3) preventing relapse, constructing a safety plan, and promoting timely linkage with outpatient aftercare services.
SAFETY PLANNING FOR MILITARY (SAFE MIL): A BRIEF INTERVENTION TO REDUCE SUICIDE RISK
Due to the limited evidence-based interventions targeted at the unique needs of military personnel with suicidal thoughts and/or behaviors, the Safety Planning for Military (SAFE MIL) study was launched to evaluate a brief, readily accessible, and personalized intervention – the Safety Planning Intervention (SPI).
The objective of the SAFE MIL study has been to adapt and to evaluate the efficacy of the SPI for service members and beneficiaries admitted for inpatient psychiatric treatment following a suicidal crisis. The SPI is a brief 60-minute single session intervention. The SPI consists of six steps: 1) warning signs; 2) internal coping strategies – self-distraction; 3) distracting social situations and people; 4) people I can ask for help; 5) professional or agencies I can contact during a crisis; and 6) making the environment safe. One of our study participants said, “It’s like knowing that the cruise line I’m on has lifeboats.”
Preliminary findings demonstrate that participants who received the SPI and reported any suicide ideation at the time of their entry into the study (versus those randomized into the control condition), showed significant reductions in both current and worst suicide ideation severity over a 6-month follow-up period.