Post-Hospital Suicide Prevention Intervention for Patients with Schizophrenia-Spectrum Disorders

People living with schizophrenia and related psychotic disorders have higher rates of suicide and the risk is particularly acute in the weeks and months following psychiatric hospitalization. Despite this, individuals with psychosis are often excluded from suicide prevention research, leaving a major gap in evidence-based interventions for this group. Existing programs rarely account for the cognitive, emotional, and social challenges unique to people with psychosis, such as disorganized thinking, social challenges, stigma, and difficulty adhering to treatment. Developing suicide prevention strategies that meet these needs is crucial, especially during the high-risk transition from the hospital.

With support from an AFSP grant, Dr. Brandon Gaudiano piloted an adapted version of the Coping Long Term with Active Suicide Program (CLASP) specifically for people with schizophrenia-spectrum disorders, known as CLASP-S. The intervention combines individual therapy, case management, and family or support-person involvement across several in-person and telehealth sessions during the six months following discharge. The approach draws on Acceptance and Commitment Therapy (ACT) principles, which help patients clarify their personal values, set meaningful goals, and build consistency between their values and daily actions alongside practical problem-solving and communication skills to help strengthen support networks. In this pilot randomized trial with 30 patients with psychosis recently hospitalized for suicidal thoughts and behaviors, CLASP-S proved safe and feasible to deliver, with most participants engaging in sessions soon after discharge, when risk was highest. Both suicidal thoughts and behaviors declined during the first three months, and no rehospitalizations, suicide attempts or deaths by suicide linked to the program. Lessons from the pilot suggest that shorter, more frequent sessions and stronger coordination with outpatient providers could further improve engagement, especially given cognitive difficulties common with psychosis. The study represents a crucial step toward developing tailored, evidence-based suicide prevention strategies for people with psychosis navigating one of the most vulnerable periods of recovery.

Citation: Benz, M.B., Rabasco, A., Everett, Y. et al. Adapting a Suicide Prevention Program for People with Psychosis Following a Psychiatric Hospitalization: Pilot Results and Lessons Learned. Int. J. Cogn. Behav. Ther. (2025). https://doi.org/10.1007/s41811-025-00260-5