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SuicideNCT03444935

Phone Call Follow-up After Crisis Centre Presentation With Suicidal Ideation and Behaviours.

A study testing Follow-up phone call in people with Suicide and Suicidal Ideation, run by Winnipeg Regional Health Authority at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This goal of this research is to examine the efficacy and feasibility of starting a phone call follow-up program for individuals discharged to the community after presenting to the Crisis Response Centre (CRC), a standalone mental health facility in Winnipeg, with suicidal ideation or behaviours. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Suicide, Suicidal Ideation, Suicide, Attempted
What is being tested?
Follow-up phone call
Could I receive a placebo?
No, everyone receives an active treatment
How many people
83 participants
Where
1 siteCanada
Study dates
14 May 2018to 20 Mar 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Being discharged to the community from the Crisis Centre
  • At least 18 years old
  • Suicidal ideation or behaviour within one week of presentation to the CRC
  • Suicidal ideation = thoughts of suicide or death, ranging from passive thoughts to organized plans
  • Suicidal behaviour = suicide attempt, interrupted suicide attempt, aborted suicide attempt, suicide preparatory actions (eg. writing a suicide note, selling off/giving away all possessions)

Who cannot join

  • Medically or cognitively unable to participate
  • Having an insurmountable language barrier
  • Psychiatrist deems that this type of follow-up could be harmful for the patient
  • Living in an institutional setting
  • Patient being admitted to hospital/treatment facility as a result of their presentation to the Crisis Response Centre
  • Being enrolled in outreach/follow up program that would directly overlap with involvement in this study
  • No reliable access to phone

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Crisis Response Centre

    Winnipeg, Manitoba, R3E 0W2

Other trials in Canada

About this study

This goal of this research is to examine the efficacy and feasibility of starting a phone call follow-up program for individuals discharged to the community after presenting to the Crisis Response Centre (CRC), a standalone mental health facility in Winnipeg, with suicidal ideation or behaviours. Currently there is no worldwide gold standard for how best to follow-up with individuals following presentations to health services with suicidal ideation or behaviours, despite the period immediately after discharge from mental health services being identified as a period of increased risk for death by suicide (Chung et al., 2017; Steeg et al., 2012). This risk is higher still for individuals who specifically had suicidal ideation or behaviours as a component of their reason for presenting to mental health services (Chung et al., 2017). One strategy that has been employed to mitigate this risk is brief contact interventions (BCI), which involves following up with people through text, phone calls, or written messages. Research has shown that this type of follow-up is well-received by individuals and although some studies have found this strategy reduces the rates of suicidal behaviours during this high-risk period, the overall literature shows mixed results (Miller et al., 2017; Exbrayat et al., 2017; Cebria et al., 2016; Milner et al., 2015; Morthorst et al., 2012; Fleischmann et al., 2008; Cedereke et al., 2002).

Because the research on phone call follow up programs has been mixed, we will be conducting a brief trial to study the efficacy and feasibility of a phone call follow-up system in Winnipeg to inform whether or not this type of program would be of benefit to the community. In order to best study this, we will be conducting a randomized control trial for individuals who are discharged to the community after presenting to the CRC with a recent history of suicidal thoughts or behaviours. Participants will be randomized into either an intervention group or a control group. All participants will receive at least one and no more than five phone calls during the five-week period immediately following discharge from the CRC, and the content and timing of these phone calls will be different depending on which group a participant is randomized to. We will rely on both self-reported data, which will be collected in a formalized fashion, and data in the electronic medical records of participants to analyze this intervention. Our hypothesis is that the specific protocol we have designed to follow up with the intervention group will result in decreased suicidal thoughts and behaviours in the period immediately following discharge.

Read the detailed description

The proposed randomized control trial will occur over a three-month period at the Crisis Response Centre (CRC) in Winnipeg. The CRC serves as a standalone facility that offers 24/7 walk in assessment and treatment for adults with mental health crises, as well as referrals to mental health services. All individuals who present to the CRC and report any suicidal ideation or behaviour within the one week prior to their presentation will be considered eligible for the study. Further inclusion and exclusion criteria are outlined in the "Eligibility" section. A variety of employees at the CRC will be involved in different roles to assist with this research.

In current practice, all individuals are able to connect with Crisis Clinicians working at the CRC both in person and through the use of a telephone call to the Mobile Crisis Unit, which provides the capacity for Crisis Clinicians to both talk on the phone to individuals or leave the CRC and assess individuals offsite to support them. All individuals who connect with Crisis Clinicians in any of these capacities have a Mental Health Assessment (MHA) completed by Crisis Clinicians. All Crisis Clinicians are trained specifically in how to assess and assist individuals with suicidal thoughts or behaviours, therefore making them optimal individuals to assist in this research given their experience to support the safety of individuals in crisis.

Participants who present to the CRC, are deemed appropriate for participation in the study based on inclusion and exclusion criteria, and who are otherwise ready for discharge back into the community will be consented by the same Crisis Clinician who completed their MHA. Participants will be informed that they will receive no less than one and no more than five phone calls over the five weeks immediately following the date of their discharge from the CRC as part of this study, without informing them of the specific differences between the intervention and control groups. Individuals will decide prior to discharge whether they would like to participate, and those who choose to participate will provide a phone number that they can be contacted at and that messages can be left on.

Individuals who choose to participate will be randomized to either a control or intervention group based on a coin flip done by the Attendants (Front Desk Staff at the CRC). The Crisis Clinician will not be involved in the randomization process to prevent allocation bias. Once participants are randomized, they will be informed by the Attendants of the exact dates on which they should expect phone calls without revealing to the participant what group they have been randomized to, thereby blinding the participants. This blinding is possible because we have concealed the exact number and nature of phone calls that will occur for the two groups. Attendants will update a schedule after randomizing each participant with appointment times for all phone calls required for the study.

On each day, Team Leads will be responsible for reviewing the schedule and allocating all required phone calls between themselves and the Crisis Clinicians working that day. Crisis Clinicians will attempt to call participants a maximum of three times on the assigned day between 0800 and 2200. All Crisis Clinicians are provided with scripts to follow for phone calls based on which group they are calling and at what time. If Crisis Clinicians are unsuccessful at contacting the participant by the third attempt, they will leave a scripted voicemail offering support and encouraging the participant to call back. If at any point during phone conversations the Crisis Clinician has concerns about a participant's safety or suicide risk, this will be approached in the same way the Clinician would approach anyone who calls in to the Mobile Crisis Unit with suicidal ideation or behaviours.

Crisis Clinicians will record the outcome and content of all phone calls into the electronic medical record, including phone calls where they do and do not successfully talk with the participant. Throughout the study, Dr. Laura Sutherland will be reviewing the participants' electronic medical records with particular attention to mental health diagnoses, visit history during the study time, and the notes from all phone calls made. This information will be used to analyze all of the data in a deidentified fashion. Crisis Clinicians and Team Leads will also keep a daily tally of the total number of individuals considered appropriate for the study based on inclusion and exclusion criteria, and how many of these individuals decline participation in the study to further inform the analysis.

Being tested
Follow-up phone call
Keywords
Phone, Brief Contact Intervention, Caring Contact, Follow-up, Suicide, Suicidal Ideation, Suicidal Behaviour, Suicide Attempt
Medical subject headings
Suicide, Suicidal Ideation, Suicide, Attempted, Self-Injurious Behavior

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Follow-up phone callBehavioural

    Please see arm/group description.

Study groups in NCT03444935
Study groupRoleWhat they receive
InterventionExperimentalParticipants randomized to the intervention group will receive a predetermined amount of follow-up phone calls after discharge from the Crisis Centre. They can expect a minimum of one call and a maximum of five calls over the five week period immediately following discharge to the community. The number and nature of phone calls they receive will be different from participants in the control group. Participants will be informed upon discharge of the dates they should anticipate phone calls, but it will not be revealed to them which group they were randomized to.
Receives: Behavioral: Follow-up phone call
ControlOtherParticipants randomized to the control group will receive a predetermined amount of follow-up phone calls after discharge from the Crisis Centre. They can expect a minimum of one call and a maximum of five calls over the five week period immediately following discharge to the community. The number and nature of phone calls they receive will be different from participants in the intervention group. Participants will be informed upon discharge of the dates they should anticipate phone calls, but it will not be revealed to them which group they were randomized to.
Receives: Behavioral: Follow-up phone call

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Suicidal ideation (frequency)

    Self-report of any thoughts of ending own life, from passive thoughts to formal plans.

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

  2. Suicidal behaviours (frequency)

    Self-report that includes a gradation of behaviour: suicide attempt, interrupted attempt, aborted attempt, or suicide preparatory act (eg. writing suicide note, selling off possessions). Note that death by suicide is also included in this category (but will only be available if family/friends of participant reports).

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

Secondary outcomes (5)
  1. Non-suicidal self harm (frequency)

    Self-report of any self-harm without the intention of ending own life.

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

  2. Health care utilization (frequency)

    Self-report of any health care utilization, including Crisis Centre, Emergency Department, Urgent Care, Crisis Hotlines, Family Physician, Walk In Clinics. Also collected through review of visit history with entrance complaint in electronic medical records.

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

  3. Perceived mental health

    Self-report of mental health using Likert-scale questioning

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

  4. Perceived improvement in mental health

    Self-report of perceived improvement in mental health using Likert-scale questioning

    Measured: Self-report; outcome pertains to perceived improvement since the date of enrollment.

  5. Satisfaction with and perceived helpfulness of phone calls in reducing suicidal thoughts and behaviours.

    Self-report of satisfaction with, perceived helpfulness of phone call follow-ups in reducing suicidal thoughts and behaviours using Likert-scale questions

    Measured: Self-report; outcome pertains to frequency over the entire five weeks.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Feb 2018
  2. Study start14 May 2018
  3. Primary completion1 Jan 2020
  4. Study completion20 Mar 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are randomized to one of two groups: intervention or control. Participants will receive a set number of follow-up phone calls based on the group to which they are randomized.
Masking
Single blind
Who is masked
Participant
Enrolment
83 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03444935
Sponsor's protocol ID
PCF2018
Status last verified
May 2025
First submitted
19 Feb 2018
Last updated
16 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Chung DT, Ryan CJ, Hadzi-Pavlovic D, Singh SP, Stanton C, Large MM. Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017 Jul 1;74(7):694-702. doi: 10.1001/jamapsychiatry.2017.1044.

    PubMed 28564699
  • Steeg S, Kapur N, Webb R, Applegate E, Stewart SL, Hawton K, Bergen H, Waters K, Cooper J. The development of a population-level clinical screening tool for self-harm repetition and suicide: the ReACT Self-Harm Rule. Psychol Med. 2012 Nov;42(11):2383-94. doi: 10.1017/S0033291712000347. Epub 2012 Mar 7.

    PubMed 22394511
  • Fleischmann A, Bertolote JM, Wasserman D, De Leo D, Bolhari J, Botega NJ, De Silva D, Phillips M, Vijayakumar L, Varnik A, Schlebusch L, Thanh HT. Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries. Bull World Health Organ. 2008 Sep;86(9):703-9. doi: 10.2471/blt.07.046995.

    PubMed 18797646
  • Milner AJ, Carter G, Pirkis J, Robinson J, Spittal MJ. Letters, green cards, telephone calls and postcards: systematic and meta-analytic review of brief contact interventions for reducing self-harm, suicide attempts and suicide. Br J Psychiatry. 2015 Mar;206(3):184-90. doi: 10.1192/bjp.bp.114.147819.

    PubMed 25733570
  • Miller IW, Camargo CA Jr, Arias SA, Sullivan AF, Allen MH, Goldstein AB, Manton AP, Espinola JA, Jones R, Hasegawa K, Boudreaux ED; ED-SAFE Investigators. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study. JAMA Psychiatry. 2017 Jun 1;74(6):563-570. doi: 10.1001/jamapsychiatry.2017.0678.

    PubMed 28456130
  • Cebria AI, Parra I, Pamias M, Escayola A, Garcia-Pares G, Punti J, Laredo A, Valles V, Cavero M, Oliva JC, Hegerl U, Perez-Sola V, Palao DJ. Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: controlled study in a Spanish population. J Affect Disord. 2013 May;147(1-3):269-76. doi: 10.1016/j.jad.2012.11.016. Epub 2012 Dec 6.

    PubMed 23219058
  • Exbrayat S, Coudrot C, Gourdon X, Gay A, Sevos J, Pellet J, Trombert-Paviot B, Massoubre C. Effect of telephone follow-up on repeated suicide attempt in patients discharged from an emergency psychiatry department: a controlled study. BMC Psychiatry. 2017 Mar 20;17(1):96. doi: 10.1186/s12888-017-1258-6.

    PubMed 28320345
  • Morthorst B, Krogh J, Erlangsen A, Alberdi F, Nordentoft M. Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial. BMJ. 2012 Aug 22;345:e4972. doi: 10.1136/bmj.e4972.

    PubMed 22915730
  • Cedereke M, Monti K, Ojehagen A. Telephone contact with patients in the year after a suicide attempt: does it affect treatment attendance and outcome? A randomised controlled study. Eur Psychiatry. 2002 Apr;17(2):82-91. doi: 10.1016/s0924-9338(02)00632-6.

    PubMed 11973116

Questions about this trial

What is this clinical trial studying?

A study testing Follow-up phone call in people with Suicide and Suicidal Ideation, run by Winnipeg Regional Health Authority at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Suicidal ideation (frequency) (time frame: Self-report; outcome pertains to frequency over the entire five weeks.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03444935, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2025; AzTrials last refreshed its copy on 1 Nov 2026.

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