Psychiatry · 3 h ago
Culturally adapted Caring Contacts show no added benefit in suicide outcomes
A randomized clinical trial enrolled 709 American Indian and Alaska Native adults with active suicidality across five communities. Over 12 months, suicidal ideation and suicide attempts decreased in both groups, but Caring Contacts did not significantly improve outcomes compared with optimal available resources alone.
- Trial enrolled 709 adults across five Indigenous communities.
- Both groups had lower suicidal ideation and attempt rates.
- No significant added benefit from Caring Contacts.
- 12-month follow-up data were available for 64%.
The CARE study was a blinded, two-group randomized clinical trial conducted from 2018 to 2023 in five American Indian and Alaska Native communities. It enrolled 709 English-speaking adults with active suicidality. Participants received either optimal available resources alone or those resources plus culturally adapted Caring Contacts: brief, non-demanding messages expressing care, sent by text or greeting card over 12 months. Outcomes included suicidal ideation, suicide attempts and suicide-related hospitalizations. The mean baseline suicidal ideation score was 42.0, and 85.2% of participants had previously attempted suicide.
At 12 months, mean suicidal ideation scores fell from 41.4 to 22.7 in the Caring Contacts group and from 42.5 to 23.1 in the control group. The proportion reporting a past-year suicide attempt also declined in both groups: from 48.0% to 14.2% with Caring Contacts and from 43.4% to 16.4% with control. The study found no statistically significant between-group differences. Follow-up data were available for 454 participants (64.0%).
The findings do not show an added benefit from Caring Contacts over the available resources used in the trial. Improvements in both groups may reflect several factors, including baseline engagement or other components of care; the study does not establish which explanation is responsible. Results apply to the enrolled communities and population, and follow-up was incomplete.
In practice
For American Indian and Alaska Native adults with active suicidality in the five participating communities, culturally adapted Caring Contacts added to optimal available resources did not significantly improve suicidal ideation or suicide-attempt outcomes over resources alone across 12 months. The similar reductions in both groups do not establish that either approach caused the changes, and the study reported follow-up data for 64% of participants. The results do not support claiming an added clinical benefit from Caring Contacts in this trial; they do not rule out effects in other populations or settings.
AI-generated clinical interpretation · Not editor-reviewed
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JAMA Network Open: Caring Contacts and Suicidality Among American Indian and Alaska Native Communities ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.