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ViewAttendees 4

Symposia

Suicide and Self-Injury

Session: Suicide risk protocols in digital monitoring studies: Considerations, implementation, and outcomes

2 - (SYM 38) Suicide Risk Assessment Protocol for Digital Monitoring Studies

Friday, November 17, 2023
2:30 PM – 4:00 PM PST
Location: Skagit (603), Level 6

Despite the importance of suicide prediction and prevention, it is among the greatest unmet challenges in mental healthcare, as prediction has not improved over 50 years of research (Franklin et al., 2017). Risk for suicide is dynamic, as suicidal urges are transient and fluctuate substantially (Kleiman et al., 2017), and there is urgent need for tools for short-term prediction of imminent risk. Healthcare professionals need to know who is at risk, why, and when through improved understanding and prediction of the temporal processes involved in suicide risk. Digital monitoring – or the gathering of intensive longitudinal, real-time mobile data – is optimally suited to serve this precision psychiatry approach to suicide prevention. However, digital monitoring of suicidal urges and behaviors presents a particular challenge in managing intensively assessed risk-related information from multiple participants, assessed multiple times per day. Additionally, given that this research moves measurement out of the lab and into daily life, participants’ locations are typically unknown. We present a detailed risk management protocol for digital monitoring suicidal thoughts and behaviors (STBs), used and refined for four years in large, multisite studies recruiting from psychiatric emergency departments and inpatient units, for both adults and adolescents at high risk for suicide. This protocol has been used in digital monitoring studies of >900 research participants for over 4 years, with nearly 700 instances of risk alerts based on participant responses and prompting use of our high-risk procedures. We describe our staffing, training, and team-based approach to continuous risk monitoring in these studies as well as lessons learned through the use of this protocol.