“PROJECT LIFE FORCE-GERIATRIC”: A NOVEL SUICIDE SAFETY PLANNING GROUP TREATMENT

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Introduction Older Veterans are the largest and fastest growing segment of the Veteran population. Additionally, the rates of suicide completion are highest in older Veterans; 68% of all deaths by suicide are in Veterans that are 50 and older. [1] Lethality of attempts is also greatest in the geriatric population. Youth typically have 25 attempts per one completed suicide, whereas older adults have only four attempts per one completed suicide. [2] Despite their elevated risk, there is limited research and fewer interventions targeting suicide risk in older Veterans. Therefore, there is an urgent need for effective interventions in reducing the risk of suicide in the geriatric population. Our research team hopes Project Life Force-Geriatric (PLF-G) can fill this gap in treatment. Methods Creating a Suicide Safety Plan (SSP) is an effective treatment for Veterans with suicidal ideation and behaviors [3,4]. PLF is an open-label, 6-month study conducted at the James J. Peters VA Medical Center, that piloted a skills group consisting of ten sessions implementing the SSP in Veterans deemed high risk for suicide. However, this PLF pilot sample only included individuals aged 25-66 years old (average: 46.43 years). To target the high-risk geriatric population, our research team is developing PLF-G. In adapting PLF-G for older adults, accommodations have been made for potential hearing and vision impairments as well as limitations in attention spans among older adults who may have mild deficits in working memory and short-term memory. These modifications include: frequent breaks during sessions, writing key points and agenda items on the white board in large print, using select assessments targeted specifically to geriatric population (e.g. the Geriatric Depression Scale), sessions will be 60-minutes (vs. 90-minutes in PLF pilot), paper handouts in addition to mobile applications, and written summaries for each session using large fonts. See Table 1. Results PLF-G specific data will be included in final presentation, but is not yet available. Below are results from the initial PLF study. In the initial PLF study, Veteran participants were assessed at baseline and post intervention (month 3). Demographic information was collected on 37 participants. The average age was: 46.43 years old (range: 25-66 years). Males accounted for 78%. This was a diverse sample with 52.6% identifying as Hispanic. The PLF study resulted in a statistically significant decrease in suicidal ideation, suicidal behavior, hopelessness, and depression as measured by the Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and the Beck Scale for Suicide Ideation (BSS). See Figure 1. There were no suicide attempts or completions throughout the course of treatment. A paired samples t-test was performed to compare pre- and post-intervention scores and there were significant decreases in: 1. Suicidal ideation on the BSS; t(20) = 4.41, p = 0.000 2. Depressive symptoms on the BDI-II; t(20) = 3.989, p = 0.001 3. Hopelessness on the BHS; t(20) = 2.330, p = 0.030 Conclusions The initial PLF decreased suicidality in a non-geriatric Veteran population. During this preliminary treatment, the 80-page manual was finalized, the program yielded encouraging results, it was well tolerated, feasible, and effective in reducing suicidal ideations and behaviors. One significant limitation to the pilot study was the lack of representation of high-risk geriatric patients; therefore, a new pilot study titled PLF-G will be conducted within the geriatric population beginning in January 2019. The results of which will be included in final presentation. This research was funded by This research was supported by VA Merit Award (RX-001911-01A1) and the VISN 2 South MIRECC.