Preliminary Effectiveness of Adjunct Mindfulness-Based Cognitive Therapy to Prevent Suicidal Behavior in Outpatients Who Are at Elevated Suicide Risk

Suicidal behavior is an important public health problem. A few efficacious treatments to prevent suicidal behavior exist. The feasibility and broad applicability of these interventions to suicidal individuals are, however, limited. We thus developed a novel, nine-session protocol combining mindfulness-based cognitive therapy (MBCT) specifically tailored to address suicide-related concerns with the Safety Planning Intervention, a brief intervention focused on developing individual suicide crisis coping skills. Here, we report on the feasibility, acceptability, safety, and preliminary effectiveness of the intervention, mindfulness-based cognitive therapy to prevent suicidal behavior (MBCT-S). Eighteen high suicide risk psychiatric outpatients in treatment were enrolled and assessed for suicidal ideation, depression, and hopelessness using well-validated clinician-administered or self-report instruments. All participants received adjunct MBCT-S. Assessments were repeated at MBCT-S termination. To measure feasibility, acceptability, and safety, we calculated enrollment, drop out, and treatment completion rates. We also summarized satisfaction rating scale data, counted adverse events, and examined qualitative data. We found significant reductions in suicidal ideation and depressive symptoms, but not hopelessness, with MBCT-S treatment. The treatment was also feasible, acceptable, and safe for participants. Directions for future study of MBCT-S are discussed.