Randomized trial with at-risk service members comparing a help-seeking intervention vs. control interventions to encourage help-seeking and thereby reduce suicide risk.

Suicide rates have increased in the U.S. military in recent years, which has prompted many researchers to look at how clinicians are treating those experiencing suicidality. Although efficacious interventions and treatments exist connecting individuals at elevated risk to behavioral health care services, these connections remain an uphill battle. Less than one third of service members with mental health problems, including those at elevated suicide risk, access care. Thus, increased efforts are needed to connect military service members at elevated suicide risk to evidence-based treatments.

One persistent barrier to help-seeking is stigma. Self-stigma, defined as one’s own stigmatizing attitudes about help seeking (e.g., “I am weak if I seek treatment”) poses a particularly significant barrier to care for those at elevated suicide risk and especially for military service members. Strikingly few interventions exist to reduce help-seeking stigma and increase connection to care among military service members. Pilot data previously collected by this study team found promising results when using a novel web-based intervention, cognitive bias modification (CBM) for help-seeking stigma (CBM-HS). 

Drs. Joiner and Gutierrez plan to build off this pilot data by conducting an RCT on the CBM-HS intervention designed to target stigma-related cognitions among individuals at elevated suicide risk not currently engaged in behavioral health treatment. Interventions that leverage CBM principles involve the completion of brief, web-based tasks in which participants are presented with a series of stimuli (e.g., words, sentences) and are trained to respond to those stimuli in a manner that is positive or neutral, rather than negative and unhelpful. Consistent with the general theoretical rationale for Cognitive-Behavioral Therapy, CBM interventions function by reshaping negative cognitions. If shown to be effective in reducing help-seeking stigma, enhancing intentions to seek care, and increasing help-seeking behaviors, this study has the potential to contribute to a decrease in suicide rates among U.S. military service members.