New Research Suggest Benefits of Telehealth BCBT for Treating Suicidal Thoughts, Mitigating Attempts

Brief cognitive behavioral therapy (BCBT) can effectively lower rates of suicidal ideation and suicide attempts, according to new research published in JAMA Open Network that evaluated the effectiveness of telehealth-delivered BCBT.¹

Suicide remains a pertinent public health concern, with the World Health Organization reporting that suicide leads to the death of over 720,000 people each year. Furthermore, among those aged 15 to 29 years, suicide is the third leading cause of death.²

Not enough research has unearthed the potential benefits of telehealth-delivered mental health services to address suicide-related concerns | image credit: insta-photos - stock.adobe.com

The present authors indicate how rates of suicide in the US continue to rise.¹ While effective and proven approaches to address suicide risks are out there, however, there is insufficient evidence regarding their effectiveness over telehealth platforms. As the use of telehealth has become more prominent following the COVID-19 pandemic,³ examining the reliability of mental health treatments like virtual BCBT is an important venture.

This phase 2 randomized control trial compared BCBT with present-centered therapy (PCT), which has demonstrated benefits for mitigating suicidal ideation and the severity of psychiatric symptoms, the authors wrote. Patients were enrolled in this study between April 2021 and September 2023 and were recruited from an outpatient psychiatry and behavioral clinic stationed in the midwestern US. They were either self-referred or received a referral from a variety of health care providers. Participants needed to be at least 18 years of age, register a score of at least 5 on the Scale for Suicide Ideation (SSI), and/or have attempted suicide in the last month. Upon enrollment, they were randomly and blindly assigned to receive virtual BCBT or PCT.

Virtual follow-ups were completed at 3, 6, 9, and 12 months.

There were 96 adults in search of treatment who were included in this study. Of this group, 10.4% (n = 10) had previously attempted suicide one time and 37.5% (n = 36) reported at least 2 prior attempts. Mean SSI baseline scores were 15.0. A suicide attempt was classified as any aborted, interrupted, or actual attempt for this study.

At the 1-year mark, 12 individuals from the PCT group registered 56 suicide attempts (n = 7 actual, 19 interrupted, and 30 aborted) compared with 11 individuals in the BCBT group who registered 36 attempts (n = 5 actual, 6 interrupted, 25 aborted). Although these rates are similar, analysis with the Anderson-Gill model indicated that those in the BCBT group carried a 41% reduced risk of attempting suicide compared with those in the PCT group (HR, 0.59; 95% CI, 0.36-0.96; P = .03).

Each treatment had a similar and significant impact for reducing the severity of suicide ideation (P < .001) but these effects did not significantly differentiate either group (P = .91).

The authors concluded by highlighting their study as the first—to their knowledge—to demonstrate the effectiveness of telehealth to bring down suicide attempts and diminish the severity of suicide ideation. “The present results provide further support for the effectiveness of BCBT for preventing suicide attempts among adults with elevated risk for suicide and indicate the treatment’s effect on reducing suicide attempts is preserved when delivered remotely via video-based telehealth,” they wrote.

References

1. Baker JC, Starkey A, Ammendola E, et al. Telehealth brief cognitive behavioral therapy for suicide prevention: a randomized clinical trial. JAMA Netw Open. 2024;7(11):e2445913. doi:10.1001/jamanetworkopen.2024.45913

2. Suicide. WHO. Updated August 29, 2024. Accessed November 12, 2024. https://www.who.int/news-room/fact-sheets/detail/suicide

3. Shaver J. The state of telehealth before and after the COVID-19 pandemic. Prim Care. 2022;49(4):517-530. doi:10.1016/j.pop.2022.04.002