Brief Skills for Safer Living (Brief-SfSL)

There are 2 million people in Canada at risk of death from suicide and suicide rates have not changed in the last 10 years. The COVID-19 pandemic also increased suicide risk and intensified a pre-existing lack of access to vital mental health services, with wait lists up to 1 year. To address this issue, the investigators developed "Brief Skills for Safer Living" (Brief-SfSL), a single-session individual psychotherapy intervention with the potential to make it easier to access care and shorten the time for people to access intervention. Derived from the proven success of the original SfSL 20-week group therapy, Brief-SfSL goes beyond conventional approaches by helping individuals understand their suicidal thoughts, build skills to manage these thoughts, and stay safe during crises. The strong results of the investigators single-arm trial of virtually-delivered Brief-SfSL in 77 adults with suicidal ideation across Canada show that Brief-SfSL is a feasible, acceptable, and safe intervention that has the potential to reduce suicide risk. To prove that it is, the investigators need to expand their study to include a treatment as usual (TAU) comparison group in a randomized controlled trial (RCT). The investigators will conduct an RCT that includes 2 groups: 75 participants who will receive TAU plus Brief-SfSL, and 75 who will receive TAU and be on a 3-month wait-list for Brief-SfSL. The aim is to compare the efficacy of Brief-SfSL vs. TAU on suicidal ideation and proxies for suicide risk (e.g., depression, anxiety) over 3 months. If the results confirm the efficacy of Brief-SfSL over TAU, this will provide definitive data to support the broad implementation of Brief-SfSL in hospitals and community mental health agencies across Canada. Study results will also be used to plan trials to assess the long-term impact of Brief-SfSL on suicide risk, healthcare system utilization, and health economics. Through this research, the investigators aim to save lives and also shift the paradigm of mental health intervention on a national scale.

• Change in depression symptoms using the Quick Inventory of Depressive Symptoms 16-item scale (QIDS). [Time frame: From baseline to 3 months post-intervention]
• Change in anxiety symptoms using the Generalized Anxiety Disorder 7-item scale (GAD-7) [Time frame: From baseline to 3 months post-intervention]
• Changes in anhedonia using the Dimensional Anhedonia Rating Scale (DARS) [Time frame: From baseline to 3 months post-intervention]
• Changes in feelings of social connectedness and burdensomeness using the Interpersonal Needs Questionnaire (INQ) [Time frame: From baseline to 3 months post-intervention]
• Changes in work, social and family functioning using the Sheehan Disability Scale (SDS) [Time frame: From baseline to 3 months post-intervention]
• Changes in emotional dysregulation using the Difficulties in Emotion Regulation Scale - Short Form (DERS-SF) [Time frame: From baseline to 3 months post-intervention]
• Changes in executive control using Space Explorer (gamified behavioural task) [Time frame: From baseline to 3 months post-intervention]
• Changes in social problem-solving using Jungle Treasure Hunt (gamified behavioural task) [Time frame: From baseline to 3 months post-intervention]
• Participant safety as measured by adverse events [Time frame: Through study completion, an average of 3 months]
• Suicide severity differences between groups as measured by the Columbia Suicide Severity Rating Scale (C-SSRS) [Time frame: Through study completion, an average of 3 months]