St. Luke’s-led suicide prevention study published in leading psychiatry journal

BOISE, Idaho – A St. Luke’s-led study published in the American Journal of Psychiatry has identified important differences in how phone and text message follow-up support may help reduce suicide risk among teens and adults, offering new insights for healthcare organizations working to prevent suicide.

The study, known as the Suicide Prevention Among Recipients of Care (SPARC) Trial, compared two evidence-based approaches used to support people after they are identified as being at risk for suicide: Instrumental Support Calls, which focus on problem-solving, resource navigation and getting connected to mental health treatment; and Caring Contacts, which provide connection and support over 12 months through two-way text messages. The study was designed to better understand which approach works best to prevent suicidal thoughts and behaviors in teens and adults.

The SPARC Trial enrolled 1,520 teens and adults who screened at risk for suicide during visits to St. Luke’s primary care clinics and emergency departments, making it one of the largest studies of its kind.

The findings showed that both approaches helped reduce suicide risk, but the most effective form of follow-up care differed by age group. Among teens, Caring Contacts text messages resulted in lower suicide risk scores and 2.5 times fewer teens reporting suicide attempts during the latter half of the study. Among adults, supportive phone calls were associated with lower suicide risk and loneliness during the first six months, while both approaches were similarly effective after one year.

“The most important finding is that suicide prevention follow-up care is not necessarily one-size-fits-all,” said Radin, DrPH, MPH, principal investigator of the SPARC Trial and research scientist with St. Luke’s. “Our results suggest that teens and adults may benefit from different types of support, which could help healthcare organizations better tailor follow-up care to meet patients’ needs.”

Suicide remains a serious public health issue and a leading cause of death in the United States (US). Idaho has the 6^th highest suicide rate in the US. Nearly half of people who die by suicide seek health care within a month of their death, often through a primary care clinic or emergency department. The U.S. National Strategy for Suicide Prevention recommends follow-up care for patients at risk for suicide using an evidence-based intervention such as instrumental support calls and Caring Contacts texts, especially during and following care transitions, when suicide risk often escalates. Implementing the best follow-up care model may reduce suicidal thoughts and behaviors.  

SPARC is the first study to directly compare these two evidence-based follow-up approaches in both teens and adults. It is also the first to have non-clinicians deliver the follow-up care. Trained follow-up specialists at the Idaho Crisis and Suicide Hotline delivered the phone calls and text messages for SPARC. This model could be realistically replicated to support follow-up care for patients, including in rural and underserved communities where mental healthcare providers are in short supply.  

For many participants, the impact of the support they received was deeply personal.

One participant shared, “You saved my life this year and got me to laugh again.” Another wrote, “I have appreciated your messages and they surprisingly have caught me at hard moments these past few months. They make me happy and make me feel less alone.”

“Behind every data point is a person, a family and a story,” said Radin. “We heard from participants who felt supported, connected and cared for during some of the most difficult moments of their lives. That’s what makes this work so meaningful.”

Publication in the American Journal of Psychiatry, one of the nation’s leading peer-reviewed psychiatry journals, recognizes the SPARC Trial as an important contribution to suicide prevention research and brings national visibility to the findings. The publication also highlights St. Luke’s growing role in patient-centered mental health research and its commitment to improving outcomes for people at risk for suicide.

“This publication reflects St. Luke’s commitment to improving health through innovation, research and evidence-based care,” said Jim Souza, MD, chief physician executive and executive sponsor of the SPARC Trial. “We’re proud of the work led by Dr. Radin and the entire SPARC team, and we’re encouraged by the potential these findings have to improve care for patients.”

The research was conducted by St. Luke’s in partnership with the Idaho Crisis and Suicide Hotline, the University of Washington and a local advisory board of people with lived experience of suicide. The trial was funded through the Patient-Centered Outcomes Research Institute (PCORI®).

“What makes me most hopeful is the potential for this research to improve care in our communities and beyond Idaho,” said Radin. “Every healthcare organization wants to know how best to support patients at risk for suicide. Our goal is for these findings to contribute to better outcomes for individuals and families across the country.”

Researchers hope the findings will help healthcare organizations deliver the right type of follow-up support at the right time, leading to stronger systems of care, fewer suicide attempts and, ultimately, more lives saved. To help other organizations implement similar approaches, the team developed a practical Caring Contacts Toolkit that is endorsed by the American Foundation for Suicide Prevention.