Suicide Prevention Outreach Trial (SPOT)

Adult Suicide Prevention Between-Visit Outreach Program

What is this program about?

This program is part of a research study. The study is evaluating the effectiveness of two population-based outreach programs for preventing suicide attempts among adult patients identified as at-risk for suicide. It is being conducted at Kaiser Permanente Northwest (KPNW), Kaiser Permanente Washington, HealthPartners, and Kaiser Permanente Colorado. The lead researcher is Gregory Simon, MD, MPH, a senior investigator at Kaiser Permanente Health Research Institute and a Kaiser Permanente Washington psychiatrist. The KPNW site investigator is Gregory Clarke, PhD, a senior investigator and assistant program director with the Kaiser Permenente Center for Health Research.

How are eligible patients identified?

We use electronic health records to identify outpatients aged 18 or older who report thoughts of death or self-harm “most of the days” or “nearly every day” in response to the PHQ depression questionnaire, administered during an in-person primary care or mental health specialty visit. Please note that we do not accept provider referrals or patient self-referrals into this study. 

  • One-third of patients who enroll are randomly assigned to usual care. These patients continue to receive usual care from treating primary care and mental health providers and are not contacted by study staff.
  • One-third of patients who enroll are randomly assigned to a Risk Assessment Care Management program, and one-third are randomly assigned to an online Skills Training intervention, called Now Matters Now.  Patients are invited to participate in both interventions via HealthConnect secure messaging. Providers are informed of their patients’ participation in the programs via HealthConnect secure messaging. In addition, these patients also continue to receive usual care from their regular KP healthcare providers.

What is the Risk Assessment Care Management program?

This intervention includes routine outreach via HealthConnect secure message and telephone to assess ongoing risk of suicide attempt using the Columbia-Suicide Severity Rating Scale, with additional care management to monitor and facilitate ongoing engagement in outpatient follow-up. Our care managers coordinate care with treating mental health and primary care providers using HealthConnect staff messaging (or telephone contacts if necessary). All care is documented in the patient’s electronic health record, and providers are sent regular updates on their patients’ involvement in the program via HealthConnect secure message.

What is the online Skills Training program?

This intervention uses an online skills training program called Now Matters Now to support patients in developing and using self-management skills for emotion regulation and crisis management. A skills coach will monitor each participant’s use of the program and send periodic messages to participants via HealthConnect secure messaging to encourage and support use of the program and practice of program skills. Providers are sent periodic updates on their patients’ involvement in the program via HealthConnect secure messaging.

How long will the study last?

Enrollment will continue until approximately June 2018. Each intervention will last for up to one year after a patient becomes eligible for the study.

What data will be analyzed?

We will use computerized health system records to identify medically-treated suicide attempts and suicide deaths among the three study groups during the 18 months following study enrollment.

Who can I contact if I have questions?

If you are a patient and have questions about the study, please leave your name and phone number on the confidential study voicemail 1-866-206-2977 for a return call.

If you would prefer that we not invite you to take part, please email sara.gille@kpchr.org or call 1-866-206-2977, leave your full name and phone number, and let us know you would not like to be invited.

If you are a KP provider, a study staff will send you a notification via HealthConnect staff message as soon as one of your patients is randomized into the study. You will have the opportunity to opt your patient out of the study before an invitation is sent. If you have questions about any of your patients, you can contact our study staff via HealthConnect staff messaging. For other questions about the study please email either the project manager, Sara Gille (sara.gille@kpchr.org) or the site investigator, Dr. Greg Clarke (greg.clarke@kpchr.org).