Improving Coping to Reduce Suicide Risk Following ED Discharge

July 14, 2026 updated by: Ewa Czyz, University of Michigan

Facilitating Effective Coping to Reduce Suicide Risk Following ED Discharge: A Micro-randomized Trial to Develop an Adaptive Text-based Intervention

The researchers hope to learn whether an electronic safety plan (ESP) and a supportive text messaging program are feasible and acceptable to adult patients with recent suicidal thoughts or behavior after emergency department (ED) discharge. From this study, the researchers also hope to learn how to best carry out the ESP and text messaging program to improve outcomes for patients after ED discharge.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Michigan
      • Ann Arbor, Michigan, United States, 48109
        • Recruiting
        • University Of Michigan
        • Contact:
        • Contact:
        • Principal Investigator:
          • Ewa Czyz, Ph.D.
        • Principal Investigator:
          • Adam Horwitz, Ph.D.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Individuals presenting to an ED with either:

  1. actual, interrupted, or aborted attempt in the last 4 weeks
  2. suicidal ideation within the last week

Exclusion Criteria:

  • Severe cognitive impairment or altered mental status (psychosis, manic state)
  • Severe aggression/agitation,
  • Being admitted or transferred into inpatient care,
  • Patient not owning a cell phone with text messaging capability

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Electronic safety plan (ESP) + Text-Based Support
Participants who are randomized to this arm will receive ESP during ED care and receive a text-based support program for 4 weeks after discharge, with up to 2 messages per day. The text-based program includes a microrandomized trial (MRT), where participants are randomized twice daily to receive or not receive a message.
Behavioral: Electronic Safety Plan (ESP)
Participants will receive an electronic safety plan in the ED. ESP focuses on developing a personalized coping plan to manage suicidal thoughts and urges.
Behavioral: Text support
Those in the text-based support program will receive up to 2 texts per day for a month with varying levels of tailoring, based on ESP and dynamic personalized feedback.
Experimental: Enhanced electronic safety plan (ESP) enhanced with 2 reminder text messages with ESP link
Behavioral: Electronic Safety Plan (ESP)
Participants will receive an electronic safety plan in the ED. ESP focuses on developing a personalized coping plan to manage suicidal thoughts and urges.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of eligible individuals who agree to participate
Time Frame: At the time of ED 1 day visit
At the time of ED 1 day visit
Completion of the one-month follow-up assessment survey
Time Frame: One month post-discharge from the ED
One month post-discharge from the ED
Completion of the three-month follow-up assessment survey
Time Frame: Three months post-discharge from the ED
Three months post-discharge from the ED
Number of withdrawals
Time Frame: Up to 3 months post-discharge from the ED
Up to 3 months post-discharge from the ED
Percentage of participants who remain active (in text-support condition only)
Time Frame: Up to 28 days post-discharge from the ED
Up to 28 days post-discharge from the ED
Participant satisfaction with the intervention components
Time Frame: Up to 1 months
Measured with a modified Client Satisfaction Questionnaire (CSQ).
Up to 1 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Michigan

Collaborators

National Institute of Mental Health (NIMH)

Investigators

  • Principal Investigator: Ewa Czyz, Ph.D., University Of Michigan

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 12, 2026

Primary Completion (Estimated)

February 1, 2027

Study Completion (Estimated)

February 1, 2027

Study Registration Dates

First Submitted

September 24, 2024

First Submitted That Met QC Criteria

September 25, 2024

First Posted (Actual)

September 26, 2024

Study Record Updates

Last Update Posted (Actual)

July 16, 2026

Last Update Submitted That Met QC Criteria

July 14, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HUM00244094
  • R34MH133057 (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

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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