Oral Presentation (max 25mins) The National Suicide Prevention Conference 2024

MyAccess to Psychological Therapies – Suicide Prevention (MyAPT-SP) Program: A Pilot. (101426)

Dayna Faraonio 1 , Malcolm Battersby 1 , Ben Riley 1 2 , David Smith 1 , Michael Baigent 2 , Kate Fairweather 1 , Niranjan Bidargaddi 1 , Dan Thorpe 1
  1. College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
  2. Mental Health Service, Southern Adelaide Local Health Network, Adelaide, SA, Australia

Introduction: In Australia, there are few interventions targeting the crucial first 24 hours after discharge for a suicide attempt in preventing a subsequent attempt. This presentation will describe a pilot evaluation targeting this time period, including qualitative outcomes and semi-structured interviews with a particular focus on the role of the trusted other. Aim: The pilot aimed to evaluate the feasibility and acceptability of a novel intervention that combined successful Flinders1 and overseas2,3 interventions, targeting people who had attempted suicide in emergency departments (EDs). Method: My Access to Psychological Therapies Suicide Prevention (MyAPT-SP) trial utilised self-guided workbooks introducing values-based skills that participants built upon at each session, modern technology, such as the MindTick4 app and supportive text messages, and was initiated while participants were still in the ED. The intervention encouraged the involvement of a trusted other (TO) to support participants at the highest risk of suicide. This 12-month pilot study aimed to recruit 15 people presenting to hospital EDs with a suicide attempt and provide them and their TO up to 11 sessions of a psychological intervention, by phone or internet, over 6 months. This intervention was evaluated for feasibility and acceptability using qualitative and quantitative methods. Four people with lived experience contributed to the design of the intervention, with the primary presenter having lived experience of suicidal ideation and attempts. Results: Mixed-methods analyses exploring participant recruitment, therapy delivery, and treatment adherence showed MyAPT-SP to be feasible. Additionally, thematic analysis of feedback from participants and their TOs showed the program to be acceptable. Four key themes were identified in this analysis: Process, Therapy, Program Recommendation, and Post Intervention. Acknowledging the limitations of a small sample size and lack of a control group, secondary health outcomes for participants in the pilot were also positive. Recommendations for improvement largely centre around the processes and systems required to carry out the intervention, specifically the synthesis of health data. Conclusion: This pilot study has shown MyAPT-SP to be acceptable and feasible, with enough positive outcomes to justify seeking funding for a definitive randomised controlled trial to implement recommendations and test the effectiveness of the intervention in reducing repeat suicide presentations in patients at high risk of suicide. Further research: This presentation describes the next phase of this research project involving a randomised control trial of the intervention in metropolitan and rural settings, with a greater emphasis on lived experience co-design.

  1. 1. Bidargaddi N, Bastiampillai T, Allison S, Jones GM, Furber G, Battersby M, et al. Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes. Journal of Telemedicine and Telecare. 2015;21(7):385-91.
  2. 2. Clark DM, Layard R, Smithies R, Richards DA, Suckling R, Wright B. Improving access to psychological therapy: Initial evaluation of two UK demonstration sites. Behaviour research and therapy. 2009;47(11):910-20.
  3. 3. Miller IW, Camargo CA, Arias SA, Sullivan AF, Allen MH, Goldstein AB, et al. Suicide Prevention in an Emergency Department Population The ED-SAFE Study. JAMA psychiatry. 2017;74(6):563-70.
  4. 4. Perry R, Oakey-Neate L, Fouyaxis J, Boyd-Brierley S, Wilkinson M, Baigent M, et al. MindTick: Case Study of a Digital System for Mental Health Clinicians to Monitor and Support Patients Outside Clinics. 2021.