Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website
HSRD Conference Logo



2019 HSR&D/QUERI National Conference Abstract

Printable View

4054 — Mindfulness-Based Cognitive Therapy for Preventing Suicide in Military Veterans: An Examination of Short-Term Outcomes

Lead/Presenter: Alejandro Interian,  VA New Jersey Healthcare System
All Authors: Interian A (VA New Jersey Healthcare System), Stanley B (Columbia University College of Physicians & Surgeons; New York State Psychiatric Institute), Chesin M (William Paterson University; VA New Jersey Healthcare System) Latorre M (VA New Jersey Healthcare System) St. Hill L (VA New Jersey Healthcare System) Miller R (VA New Jersey Healthcare System) King A (VA New Jersey Healthcare System) Boschulte, D (VA New Jersey Healthcare System) Gara M (Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School) Kline A (Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School)

Objectives:
A critical need exists for research on effective interventions that reduce suicide in Veterans. To address this need, a randomized controlled trial evaluated Mindfulness-Based Cognitive Therapy for Suicide (MBCT-S). Study aims were to evaluate whether MBCT-S augmented VHA treatment-as-usual (TAU) in reducing: 1) time to suicidal event (i.e., suicide behavior or suicide-related emergency service); 2) time to suicide attempt; and 3) other suicide-related factors.

Methods:
Veterans at high-risk for suicide (N = 140) were randomized to either MBCT-S+TAU or TAU only (control). Three assessments occurred over 3 months: baseline; mid-treatment; and post-treatment. Outcomes included suicidal ideation, suicide attempts, depression severity, hopelessness, distress tolerance, and suicide-related coping. Analyses adopted an intent-to-treat analytic approach.

Results:
The MBCT-S condition showed a significant advantage over control on time to a suicide attempt (p = .046). Within 100 days, 5 (7%) of MBCT-S participants made suicide attempt, compared to 13 (18.8%) in the control group (Number-needed-to-treat = 8.48). Also, MBCT S participants showed significantly greater improvements than controls in distress tolerance across time (p = .004). Significant effects were not observed for time to suicidal event, suicidal ideation, depression, and hopelessness. Since 50.7% of participants were receiving VHA residential care, stratified analyses evaluated the influence of this important TAU context. Notably, across several outcomes, MBCT-S showed a stronger advantage over control among participants receiving VHA residential treatment. Time to suicide attempt was significantly different only among participants receiving residential treatment (p = .003), not among outpatients. Among those receiving residential care, suicide attempts at 100 days occurred in 0 (0%) MBCT-S participants, compared to 9 (13.0%) controls. Similarly, only MBCT-S participants receiving VHA residential care showed significantly greater improvement over time than controls on depression (p = .032), hopelessness (p = .002), and distress tolerance (p = .002).

Implications:
MBCT-S shows promise for reducing suicide attempts and improving other key outcomes among Veterans at high-risk for suicide, particularly when received concurrently with VHA residential care.

Impacts:
A recent HSRandD evidence synthesis report noted the gap in suicide prevention studies targeting high-risk Veterans. The findings of this study directly address this gap, showing promise for an intervention, MBCT-S, that can be integrated within existing VHA programs.