Pilot Randomized Controlled Trial of the Mobile Intervention for Suicidal Thoughts

Given the dramatic increase in Veteran suicide rates in the past two decades, there is a clear need to develop innovative and effective interventions to prevent Veteran suicide. Use of mobile health (mHealth) technology could provide a low-cost method to increase the reach of suicide prevention interventions to Veterans with suicidal ideation. One of the factors that contributes to suicide risk is what is known as a “suicidal belief system.” This belief system is made up of several cognitions, including hopelessness, thwarted belongingness, perceived burdensomeness, unlovability, unbearability, and unsolvability. These cognitions have all been associated with suicide risk among military personnel. Modification of these cognitions may reduce suicidal thoughts and behaviors. Our team has developed a brief mobile intervention entitled the Mobile Intervention for Suicidal Thoughts (MIST) that uses evidence-based interpretation bias modification techniques to reduce these suicide cognitions. The goal of this project is to is to conduct a pilot trial of the MIST intervention to evaluate whether it is feasible an acceptable as an adjunct treatment for Veterans with suicidal ideation. A pilot randomized controlled trial (RCT) is proposed, in which 50 Veterans with suicidal ideation will be randomized to either MIST plus Treatment as Usual and Safety Planning versus Treatment as Usual and Safety Planning. The central hypothesis is that Veterans will find MIST acceptable and will be willing to use it to reduce their suicidal thoughts. The proposed research project will address the following Specific Aims: Aim 1: Evaluate the feasibility and acceptability of MIST as an adjunct treatment for Veterans with suicidal ideation. Aim 2: Evaluate the association between contact-time with the MIST intervention and change in suicidal cognitions; and Exploratory Aim: Assess preliminary group effects of the MIST intervention on suicidal thoughts/behaviors and functional outcomes. If shown efficacious, the public health impact of the MIST application could be enormous. MIST would provide clinicians and Veterans with an easily accessible treatment option to reduce suicidal cognitions and suicidal ideation, and improve functioning. This low-cost, easily implementable, intervention would significantly increase the reach of evidenced-based suicide prevention tools. Project Number: 1I21RX005137-01A1 | Fiscal Year: 2025 | NIH Institute/Center: Veterans Affairs (VA) | Principal Investigator: Kirsten Dillon | Institution: DURHAM VA MEDICAL CENTER, DURHAM, NC | Activity Code: I21 | Study Section: Rehabilitation Research and Development SPiRE Program[RRDS] View on NIH RePORTER: https://reporter.nih.gov/project-details/11052365