Date of Graduation

8-2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology (PhD)

Degree Level

Graduate

Department

Psychological Science

Advisor

Ana J. Bridges

Committee Member

Matthew T. Feldner

Second Committee Member

Scott H. Eidelman

Keywords

brief intervention, crisis response planning, primary care, primary care behavioral health, suicide

Abstract

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few developed protocols for management of suicide risk in this setting. This study aimed to evaluate the preliminary outcomes, acceptability, and feasibility of a brief crisis response planning intervention for patients at a moderate risk for suicide in a primary care behavioral health (PCBH) setting. The outcomes examined included change in suicidal cognitions, suicidal intent, hope, and coping efficacy. Twenty-two adult primary care patients at moderate risk for suicide participated in this study, which involved filling out self-report measures before and after creating a crisis response plan with a behavioral health consultant (BHC). Patients were contacted four months after their initial visit to complete follow-up measures and respond to open-ended questions about the intervention. So far, 16 patients have participated in the follow-up interview. BHCs were also interviewed about their perceptions of the intervention. Paired-samples t-tests evaluated changes from pre- to post-treatment, and within-subjects repeated measures ANOVAs evaluated changes across time. Thematic analysis was used to analyze responses to open-ended questions. Patients showed declines in suicidal intent within session and at follow-up. Patients did not show increases in hope or coping efficacy within session, but did demonstrate increases at follow-up. Patients did not demonstrate changes in suicidal cognitions. Patients and BHCs alike found the intervention helpful, and few had concerns about the implementation of this intervention in the PCBH model. Findings provide preliminary evidence that moderate suicide risk can be managed in primary care through integration of BHCs into the primary care team.

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