Mindfulness-Based Cognitive Therapy for Suicide Prevention

Every month the VA becomes aware of approximately 1,100 Veterans in VA care who attempt
suicide. While the VA has implemented a comprehensive, multifaceted suicide prevention
approach, it has yet to implement nationally any evidence-based psychotherapies targeting
suicide, a gap due largely to the dearth of evidence-based therapies for suicide. Primary
aims of this proposal are to conduct a randomized controlled trial testing an adaptation of a
cognitive-behavioral intervention, Mindfulness-Based Cognitive Therapy (MBCT), for Veterans
on the VA's High Risk for Suicide List. The investigators' adapted version of MBCT for
suicide (MBCT-S) integrates mindfulness meditation techniques with the VA Safety Plan to
enhance patients' awareness of suicide triggers and appropriate coping strategies. This study
has the potential to increase the range of cost effective treatment alternatives for the
large number of suicidal Veterans for whom evidence-based therapies are severely limited.

Inclusion Criteria:

The following criteria were formulated to recruit a sample at high risk for suicide
behavior.

- The subject has experienced a suicidal event during the past 30 days. A suicidal event
involves

- 1) psychiatric hospitalization due to suicidal risk,

- 2) psychiatric hospitalization if subject was already on the High Risk for
Suicide List,

- 3) suicidal ideation with suicidal intent,

- 4) suicidal preparatory behaviors, or

- 5) actual, interrupted, or aborted suicide attempt.

AND

- The subject is on or will be placed on the VA High Risk for Suicide List

- OR The subject had an actual, interrupted, or aborted attempt in the last year

- OR In the study clinician's opinion (i.e., Masters or Doctoral level study
personnel with formal mental health training) in consultation with the PI, the
suicidal event is significant enough to warrant treatment to reduce suicidal
risk.

Exclusion Criteria:

- cognitive deficits that decrease the likelihood of benefit from MBCT-S

- severe symptoms of hallucinations or delusions

- disorganized or disruptive behaviors

- medically unstable

- current mindfulness-based psychotherapy or receipt of 2 or more sessions of a
mindfulness-based psychotherapy in the last 12 months