Intensive case management linking VA and community care to prevent suicide in Veterans
Improving Access to VA Mental Health and Suicide Prevention Services: A Randomized Clinical Trial of Intensive Case Management Between VA and Community Care (SUPERCEDE RCT)
This trial will test whether SUPERCEDE, an intensive case-management program that links VA and VA-authorized community care, helps Veterans at risk for suicide get faster, better-coordinated mental health care than present-centered therapy.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | VA Eastern Colorado Health Care System Federal |
| Locations | 1 site (Aurora, Colorado) |
| Trial ID | NCT07534358 on ClinicalTrials.gov |
What this trial studies
This is a hybrid effectiveness Type 1 randomized controlled trial that will enroll about 100 VA-enrolled Veterans and randomize them to SUPERCEDE or present-centered therapy (PCT). SUPERCEDE combines Brief Cognitive Behavioral Therapy for Suicide Prevention (BCBT-SP), a Crisis Response Plan, intensive case management to address suicide risk factors, and formal coordination with VA-authorized community care. The control arm receives PCT matched in session number (3 sessions with an optional 3 additional sessions) delivered by therapists trained in both interventions. Participants are recruited through the VA Eastern Colorado Health Care System and VA records, must be able to complete online questionnaires and virtual consent, and outcomes focus on access, care coordination, suicide prevention monitoring, feasibility, acceptability, and implementation.
Who should consider this trial
Good fit: Veterans aged 18–80 enrolled in the VA Eastern Colorado Health Care System who receive VA-authorized community care, are at risk for suicide (prior attempt, recent ideation, or elevated PHQ-9/PCL-5), have psychosocial challenges and care coordination issues, and can complete online questionnaires and virtual consent.
Not a fit: Veterans not enrolled in the Eastern Colorado VA system, not receiving VA-authorized community care, outside the age range, already receiving regular mental health services, or without current suicide risk are unlikely to be eligible or to benefit from this intervention.
Why it matters
Potential benefit: If successful, SUPERCEDE could shorten delays to care, improve coordination between VA and community providers, and reduce suicide risk among Veterans receiving community care.
How similar studies have performed: Elements such as BCBT-SP and crisis response plans have shown benefit in prior studies, but integrating them with intensive case management and structured VA-community care coordination in SUPERCEDE is novel and has only been piloted previously.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: Veterans must be: * enrolled in the VA Eastern Colorado Health Care System (ECHCS) * able to complete an online questionnaire * age 18-80 years * able to comprehend and provide virtual informed consent * receiving both VA care and VA authorized community care, through the MISSION Act, which is related to any physical or mental health disorder * Veteran's non-VA care is authorized (i.e., non-VA care/treatment approved in advance by the VA) * at risk for suicide, which is defined as any 1 of the following circumstances: a) prior lifetime suicide attempt; b) suicidal ideation in the past month; c) current mental health symptoms, defined as PHQ-9 \>10, or PCL-5 \>31 * psychosocial challenges reported on the ACORN or Assessment of Needs measure * issues with VA community care coordination (i.e., Veteran reported challenges, consults canceled in medical record, appointments canceled or rescheduled in medical record, etc.) * receiving no or infrequent mental health services at the VA (e.g., seen less than once a month by a mental health provider). Exclusion Criteria: Veterans must be: * not at imminent risk of suicide or homicide warranting crisis intervention (will be able to participate once stabilized) * unable or unwilling to participate in the intervention (e.g., unwilling to provide VA community care information, etc.) * without access to a device capable of telephone calls or video calls * presenting with any situation which the principal investigator deems this type of care is inappropriate for the Veteran.
Where this trial is running
Aurora, Colorado
- Eastern Colorado Healthcare System — Aurora, Colorado, United States (Recruiting)
Study contacts
- Principal investigator: Bryann B DeBeer, PhD — Eastern Colorado Healthcare System
- Study coordinator: Bryann B DeBeer, PhD
- Email: Bryann.DeBeer@va.gov
- Phone: 254-987-0341
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.