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Suicide Behavior Results From the U.S. Army's Suicide Prevention Leadership Tool Study: The Behavioral Health Readiness and Suicide Risk Reduction Review (R4).
Curley, Ltc Justin M; Duffy, Farifteh F; Kim, Paul Y; Clarke-Walper, Kristina M; Riviere, Lyndon A; Wilk, Joshua E.
  • Curley LJM; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
  • Duffy FF; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
  • Kim PY; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
  • Clarke-Walper KM; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
  • Riviere LA; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
  • Wilk JE; Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
Mil Med ; 2022 Jun 21.
Article in English | MEDLINE | ID: covidwho-1901211
ABSTRACT

INTRODUCTION:

The U.S. Army developed a new tool called the Behavioral Health Readiness and Suicide Risk Reduction Review (R4) for suicide prevention. A 12-month evaluation study with the primary objective of testing the hypothesis (H1) that Army units receiving R4 would demonstrate improved outcomes in suicidal-behavior measures following the intervention, relative to control, was then conducted. The results of analyses to answer H1 are herein presented. MATERIALS AND

METHODS:

The R4 intervention (R4-tools/instructions/orientation) evaluation study, Institutional Review Board approved and conducted in May 2019-June 2020, drew samples from two U.S. Army divisions and employed a repeated measurement in pre-/post-quasi-experimental design, including a nonequivalent, but comparable, business-as-usual control. Intervention effectiveness was evaluated using self-report responses to suicide-related measures (Suicide Behaviors Questionnaire-Revised/total-suicide behaviors/ideations/plans/attempts/non-suicidal self-injuries) at 6-/12-month intervals. Analyses examined baseline to follow-up linked and cross-sectional cohorts, incidence/prevalence, and intervention higher-/lower-use R4 subanalyses.

RESULTS:

Both divisions demonstrated favorable in-study reductions in total-suicide burden, with relatively equivalent trends for total-suicide behaviors, total-suicide risk (Suicide Behaviors Questionnaire-Revised), suicidal ideations, and non-suicidal self-injuries. Although both demonstrated reductions in suicide plans, the control showed a more robust trend. Neither division demonstrated a significant reduction in suicide attempts, but subgroup analyses showed a significant reduction in pre-coronavirus disease 2019-attempt incidence among those with higher-use R4 relative to control.

CONCLUSIONS:

There is no evidence of harm associated with the R4 intervention. R4 effectiveness as a function of R4 itself requires confirmatory study. R4 is judged an improvement (no evidence of harm + weak evidence of effectiveness) over the status quo (no safety data or effectiveness studies) with regard to tool-based decision-making support for suicide prevention in the U.S. Army.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Milmed

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Milmed