(PS2-D91) Self- versus Clinician-administered Crisis Response Plan

Preliminary research indicates that self-administered psychological interventions may be equally or more effective than those administered by clinicians (Wagner et al., 2014; Zimmerman et al., 2018). These findings are promising for expanding the reach of interventions to those who are unable to see a clinician. This is especially true for those experiencing suicidal ideation and are at higher risk for suicide, such as military veterans, who need more urgent, accessible means of intervention that is self-administered and suicide specific. Crisis Response Planning (CRP), an efficacious intervention that reduces suicide attempts and negative affect while increasing positive affect (Bryan et al., 2017; Bryan et al., 2018), involves creating a written, personalized set of steps for immediately mitigating a suicidal crisis. Traditionally, clients collaborate with a clinician to identify warning signs of a suicidal crisis, coping strategies to use independently, and personal and professional support contacts. While preliminary evidence indicates that both clinician- and self-administered iterations of CRP are effective for reducing suicide risk, it is unknown whether the two CRP iterations differ in likelihood of completion. We expect that clinician-administered CRPs will yield more complete responses than when self-administered. The present study evaluated 38 CRPs to investigate differences between the two CRP iterations in a sample of military personnel and veterans who endorsed recent suicidal ideation. Participants were recruited from ResearchMatch and were randomized to either an online, self-administered CRP or a virtual, clinician-administered CRP. Participants’ average age was approximately 47 years old (M=46.7; SD=12.9) with the sample split evenly between men (51.5%) and women (48.5%). Only 12 of 19 participants assigned to a self-administered CRP completed all five components of the CRP, compared to 18 of 19 participants assigned to a clinician-administered CRP. A Chi-squared test found this difference to be significant (X^2(1, N=38) = 5.7, p=0.016965). Interestingly, the average word count for CRP responses when self-administered was 50.85 words (SD=25.5), while only 43.89 words (SD=22.1) when clinician administered, although this difference was not significant (t(36)=0.91, p=0.368). Future research should seek to expand on potential differences in content and efficacy between clinician- and self-administered, suicide specific interventions to improve accessibility and outcomes.