# Micro-randomized trial to assess brief, just-in-time interventions for reducing short-term suicide risk

> **NIH NIH P50** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $243,392

## Abstract

As the tenth leading cause of death in the United States, suicide is an alarmingly prevalent public health problem.
The time period of highest risk for suicide and related behavior (SRB) is immediately (e.g., the weeks) following
psychiatric hospitalization. Effective and scalable strategies for preventing SRB among individuals recently
discharged from inpatient treatment are urgently needed. Encouragingly, brief evidence-based interventions now
exist that reduce risk for suicide after acute psychiatric care. A primary example is safety planning, which involves
developing a prioritized list of coping strategies and sources of support that people can use to mitigate future
suicidal crises; this intervention is now recommended as part of standard inpatient clinical care. However, it has
been shown that well over one-third of suicidal patients who have a safety plan never use it. Additionally, little is
known about when (and for whom) specific components of the safety plan, which includes internal coping
strategies, social support activities, and help-seeking behaviors, are most accessible and effective. Optimizing
real-world safety plan use with scalable intervention strategies delivered via mobile technology has great
potential to improve the effectiveness of an already promising intervention and advance precision treatment for
high-risk individuals. This project will employ the recently developed micro-randomized trial design to test the
effectiveness of brief, just-in-time interventions aimed to promote real-world use of the safety plan and its specific
components. Both the method (e.g., phone call or text messaging by a human or automated forms of
smartphone-based messaging) and content (e.g., recommendation to use the safety plan in its entirety or a
specific component) will be randomized according to individuals' current levels of suicidal urges and intent.
Participants will be psychiatric inpatients admitted for suicidal thoughts or behaviors who agree to participate in
an intensive longitudinal monitoring protocol involving real-time smartphone-based surveys for the 28 days after
hospitalization; after each completed survey, participants will be repeatedly “micro-randomized” to one of several
just-in-time interventions. We will test the hypotheses that brief interventions will be acceptable and feasible, and
associated with increased use of safety plan components (target mechanism) and reductions in suicidal thoughts
(proximal outcome) at high, medium, and low levels of suicidal thoughts, and that intervention effects will vary
by both intervention method and content. We will also explore internal and external contextual moderators (e.g.,
affect, social support) of proximal intervention effects, and collect qualitative data that will inform intervention
refinement as well as the future development and implementation of just-in-time adaptive interventions. This
project is well-matched to the overall P50 Center emphasis on leveraging innovati...

## Key facts

- **NIH application ID:** 10904647
- **Project number:** 5P50MH129699-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Kate H. Bentley
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $243,392
- **Award type:** 5
- **Project period:** 2023-08-08 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10904647

## Citation

> US National Institutes of Health, RePORTER application 10904647, Micro-randomized trial to assess brief, just-in-time interventions for reducing short-term suicide risk (5P50MH129699-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10904647. Licensed CC0.

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