Suicide Prevention for Justice Involved Managed Care Subscribers

Managed Care Updates of Subscriber Justice System Involvement for Suicide Prevention

The goal of this clinical trial is to test the effects of a suicide prevention intervention for individuals released from jail. The main question it aims to answer is: Does the use of Caring Contacts improve subscriber engagement with healthcare services while reducing suicide-related outcomes? Participants will include subscribers of a managed care organization (MCO). Intervention includes sending subscribers Caring Contacts letters for 6-months following jail release to target healthcare re-engagement and suicide prevention.

Study Overview

• Status: Completed
• Conditions: Suicide and Self-harm
• Intervention / Treatment: Behavioral: Caring Contacts letters

• Study Type: Interventional
• Enrollment (Actual): 45155
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Rhode Island
    • Providence, Rhode Island, United States, 02906
      • Butler Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 18+ years old
• Released from an Ohio jail
• enrolled in Medicaid through CareSource

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Care as usual
Experimental: Caring Contact letters; Caring Contact letters will be mailed to a randomly selected group of managed care subscribers over a 6-month period following jail release.	Behavioral: Caring Contacts letters; Caring Contacts involves sending individuals at risk for suicide brief, non- demanding messages of care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Suicide Attempt	A suicide attempt is defined as "engaging in a potentially self-injurious behavior, associated with at least some intent to die as a result of the act." We will assess total number of subsequent attempts using the already-developed Mental Health Research Network (MHRN) algorithm for extracting suicide attempt information from claims data	6-months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
All-cause Injury and Poisoning	All-cause injury and poisoning data will be extracted from ICD-10 data.	6-months
Outpatient Behavioral Health Service Linkage	We will extract number of outpatient behavioral health (i.e., mental health or substance use) visits during the 12 months prior to and 6 months following jail release from claims data.	18 months
CareSource Member Services (CMS) Line Use	Caring Contact messages will list the CMS phone number (which is answered by the Care Management Team, who are trained to assess and connect callers to the appropriate services) as a way to reach out. Care Source will track calls to this line by subscribers in all study conditions.	6-months
Inpatient and Emergency Department Mental Health Care Visits	Data on inpatient and emergency department mental health visits will be extracted from claims data using MHRN algorithms.	6-months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Arrests	We will also extract past year and next 6 month number of arrests from the Jail-Medicaid database.	18 months

Collaborators and Investigators

• Sponsor: Butler Hospital
• Collaborators: Michigan State University
• Investigators: Principal Investigator: Sarah Arias, Butler Hospital

Publications and helpful links

General Publications

• Arias SA, Sperber K, Jones R, Taxman FS, Miller TR, Zylberfuden S, Weinstock LM, Brown GK, Ahmedani B, Johnson JE. Managed care updates of subscriber jail release to prompt community suicide prevention: clinical trial protocol. BMC Health Serv Res. 2023 Nov 16;23(1):1265. doi: 10.1186/s12913-023-10249-5.
• Arias SA, Sperber K, Jones R, Taxman FS, Miller TR, Zylberfuden S, Weinstock LM, Brown GK, Ahmedani B, Johnson JE. Managed Care Updates of Subscriber Jail Release to Prompt Community Suicide Prevention: Clinical Trial Protocol. Res Sq [Preprint]. 2023 Sep 25:rs.3.rs-3350204. doi: 10.21203/rs.3.rs-3350204/v1.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2022
• Primary Completion (Actual): September 3, 2024
• Study Completion (Actual): August 1, 2025

Study Registration Dates

• First Submitted: October 11, 2022
• First Submitted That Met QC Criteria: October 11, 2022
• First Posted (Actual): October 14, 2022

Study Record Updates

• Last Update Posted (Actual): November 12, 2025
• Last Update Submitted That Met QC Criteria: October 22, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: suicidal behavior; jail release; behavioral health providers; suicide training
• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Suicide; Self-Injurious Behavior
• Other Study ID Numbers: 1P50MH127512-01A1 8577; 1P50MH127512-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No