A new study found that when active-duty service members received caring texts from health clinicians intermittently over the course of a year, the risk of suicide attempts dropped from 15 percent to 9 percent.
The research, published in the journal JAMA Psychiatry, involved 658 randomized Army and Marine Corps personnel identified as being at risk of suicide. Participants were stationed at one of three military bases in the United States.
“Caring contacts is an entirely different way to engage and take care of suicidal individuals,” said study leader Dr. Kate Comtois, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. “It can both prevent suicidal behavior and provide support over periods of stress and transition.”
‘Caring contacts’ are brief periodic messages that express unconditional care and concern and have been previously shown to prevent suicide deaths, attempts, ideation, and hospitalizations.
On top of standard care, participants in the caring contacts group received 11 text messages delivered on day 1, at week 1, at months 1, 2, 3, 4, 6, 8 10, and 12, and on participants’ birthdays. They were called on the phone if they were feeling urgent distress.
This simple intervention builds on the work of Dr. Jerome Motto, a World War II soldier who became a psychiatrist and researcher. He used caring letters to conduct the first successful clinical trial to reduce suicide deaths.
Historically, military personnel have had a lower rate of suicide than the general population. Today, however, veterans have a 50 percent higher incidence of suicide than the general population, according to the Department of Veteran Affairs Suicide Data Report, 2006-2016.
In 2018, the U.S. military experienced the highest number of suicides among active-duty personnel in at least six years. A total of 321 active-duty members took their lives during the year (57 Marines, 68 sailors, 58 airmen, and 138 soldiers), according to Military.com.
In the new study, just under 14 percent of text responses mentioned difficulty and adversity, but after a few exchanges with a clinician, the service member felt better, said Dr. Amanda Kerbrat, a research scientist at the department of psychiatry and behavioral sciences. “Most people didn’t seem to need much to get the message that someone cared and was looking out for them,” she said.
During the study, which took place from April 2013 to September 2016, five service members indicated they were suicidal and were called by a clinician immediately, said Kerbrat.
“The intervention is ready for prime time,” said Comtois, noting that health care systems still need to sort out issues such as who will be delivering the messages as well as content guidelines. She and colleagues are currently working on a free toolkit for health care providers.