ASSIP-OA short psychological intervention for suicidal older adults

Research problem and specific questions: The overall aim is to develop and test a modified version of the Attempted Suicide Short Intervention Program (ASSIP), which we will adapt specifically for older adults (70+).

The primary study question is: Compared to treatment as usual, is the addition of the ASSIP-OA to ordinary treatment associated with a lower frequency of new episodes of serious suicidality within 6, 12 and 24 months? Secondary effect measures involve psychiatric symptoms including level of suicidal ideation as well as coping skills.

Further, an important focus is to determine if the (ASSIP-OA) is feasible, based on its acceptability, appropriateness, deliverability and fidelity. Finally, we will identify challenges and opportunities, as experienced by participants and therapists. Data and method: Del 1: RCT design with 60 persons in the ASSIP-OA group and 60 who receive ordinary care.

Del 2: Individual interviews with ASSIP-OA participants (a purposive sample, circa 15) and focus group interviews with therapists (circa 14) trained in ASSIP-OA.Relevance and utilisation: We know that older persons with mental health issues are less likely to receive care than their younger counterparts in Sweden today.

Evidence-based therapies are widely available for younger adults with mental health issues, but not for the oldest members of the population, despite the fact that their need for specialized services is at least as great. Older adults are gravely underrepresented in suicide prevention research.

It is anticipated that results of the project will not only inform the development of more a person-centered care for suicidal older adults, but also contribute to a systemic perspective on suicidal behavior in older adults, that can help to reduce both ageist thinking and the stigma still associated with suicide in our culture today.

Plan for project realisation: With active input from persons with lived experience and other stakeholders we will co-create a program that can work also for persons with milder cognitive impairment.

Participants (70+) with serious suicidality will be recruited from psychiatric services in 4 Swedish regions (Västra Götaland, Halland, Skåne, Västmanland). The intervention will include 5 sessions with a specially trained therapist. Evaluations are carried out at baseline, after session 5, and after 6, 12 and 24 months.

Qualitative interviews are carried out after the end of the therapy.