.png)
What are Caring Contacts?
Caring Contacts are brief, periodic messages sent over 1-2 years that express unconditional care and concern. They have reduced suicide, suicide attempts, and suicide ideation, are cost-effective, are recommended by multiple clinical practice guidelines, and have the potential to scale up to a single individual intervening with hundreds of suicidal individuals. However, despite this strong support, few health systems are using Caring Contacts and many who have made maladaptive adaptations that weaken core Caring Contacts principles. These maladaptive modifications occur largely because Caring Contacts activities fall outside of established workflows. Intervention administration can also be too time consuming for clinic staff or service organizations for whom valuable clinical and volunteer time should be spent with people, not paperwork. Thus, many organizations express excitement about Caring Contacts, but implementation falters in the face of what can appear to be insurmountable coordination and risk management complexities.
.jpg)
Integration
ISACC is highly usable and pilot tested and is a practical solution to the majority of reasons organizations don’t implement Caring Contacts or don’t implement them correctly. We currently offer regular training and consultation on Caring Contacts and incorporate ISACC into these trainings to increase the use of Caring Contacts.
Collaboration
We've partnered with multiple clinics and community organizations to implement one- and two-way text message Caring Contacts. Additionally, we've developed ISACC to streamline the handling of postal mail Caring Contacts, thereby reducing staff workload. Our aim is to efficiently reach more individuals experiencing suicidal thoughts or behaviors and ensure that no one falls through the cracks.
Research
A practical and efficient method of sending Caring Contacts facilitates research with veterans and active-duty service members as well as native and rural communities by our center and other research teams to improve Caring Contacts impact and efficiency.
Explore the ISACC System
Privacy and convenience for both the authors and the recipients
Caring Contacts Automated messages are prescheduled, personalized for each recipient and editable on demand
Customizable notifications to the author via email or text keep them in the loop on recipient replies
The ISACC system provides context to authors via notes and message history
Recipient Experience
Feeling suicidal is so much about feeling alone and feeling this will never change. Caring Contacts arrive periodically - weekly, monthly - over a year or more showing continued care, interest, and support with no effort from the recipient.
Caring Contacts can be offered as aftercare following hospitalization or a safety plan and has been used successfully with recipients from a variety of backgrounds - military, veteran, youth, native communities, primary care and emergency departments, healthcare providers, etc. - from around the globe including the US, Australia, and Iran.
“I actually enjoyed it, because I knew it wasn't just a computer, it was an actual message.”
“[The messages] made me value life more. Because life is valuable. It really is.”
“It helped me boost my confidence. When I was feeling down, there was somebody thinking of me and it made me feel better about myself, made me move forward. That's what those messages helped me with, gave me strength.”
“It was a good feeling to know that somebody is actually out there. Somebody thought about you today and decided to check on your wellbeing... it helped me to understand there are people that care out there. It's not just me by myself, that it's okay to talk to someone that I don't have to keep it all bottled up.”
Author Experience
Our aim is to make sending Caring Contacts almost as effortless as receiving them. Though we may never fully achieve that, ISACC securely tracks all the necessary details, ensuring that the correct messages are sent to the appropriate individuals at the right moment. It alerts you with a secure link to key information to know what to do when someone responds. ISACC allows for secure replies from both phones and computers.
Why ISACC was developed
The suicide rate has increased 28% over the past two decades while heart disease, diabetes, and cancer mortalities have declined. Since 2011, new standards have led to improved suicide risk screening and risk management. Treatment, however, has lagged because delivering most well-established psychotherapies at scale is infeasible. Thus, the need for suicide prevention has skyrocketed without available resources to meet demand. In addition, the COVID-19 pandemic has caused profound psychological and social effects and has exacerbated the demand for telehealth and technology-mediated communications. The necessity for an accelerated shift to highly scalable and technology-based solutions for suicide prevention will not be reversed. The suicide rate has increased 28% over the past two decades while heart disease, diabetes, and cancer mortalities have declined. Since 2011, new standards have led to improved screening and management of suicide risk. Treatment, however, has lagged because it's impractical to provide most widely recognized forms of psychotherapy on a large scale. Thus, the need for suicide prevention has skyrocketed without available resources to meet demand. In addition, the COVID-19 pandemic has caused profound psychological and social effects and has exacerbated the demand for telehealth and technology-mediated communications. There’s a pressing need to quickly adopt scalable, technology-driven approaches for preventing suicide.
How ISACC was developed
Based on our research, we have adapted Caring Contacts for text message and demonstrated its feasibility and acceptability in three studies. We have conducted a cultural adaptation of Caring Contacts for the military, native communities and a rural/frontier health system in Idaho. We have also seen Caring Contacts is both feasible and acceptable in five native communities when sent by lay members of the community who don’t have clinical training. While a licensed clinician was available, she was unneeded after the initial training period. To facilitate scaling of Caring Contacts, we have used biomedical informatics and software development methods including human-centered design, natural language processing, agile prototyping, and electronic health record integration, to design a web-based application “Informatics Supported Authorship of Caring Contacts” or ISACC that makes Caring Contacts usable for service organizations staffed by non-clinicians as well as clinical care.
About Us
The Center for Suicide Prevention and Recovery (CSPAR) teamed up with the Clinical Informatics Research Group (CIRG) and experts in Human Centered Design and clinical decision support tools to develop ISACC.
The Center for Suicide Prevention and Recovery promotes the recovery of individuals experiencing suicidal thoughts and behavior and the effectiveness and resilience of the clinical staff and families who care for them through
- conducting rigorous and ecologically valid research
- developing innovative interventions
- improving policies, systems and environments of care
- providing expert training and consultation
- listening to and understanding the lived experience of those we serve
The Clinical Informatics Research Group designs, develops, builds, and operates information systems that securely manage health information for projects in the Clinical, Public Health, and Global Health Informatics domains.
Support for the development of ISACC came from the Garvey Institute for Brain Health Solutions and the Face the Fight™.
Project Team
Center for Suicide Prevention and Recovery
Kate Comtois, Director
Barbara Wright
Anna Evanson
Clinical Informatics Research Group
William Lober, Director
Justin McReynolds
Amy Chen
Sierramatice Karras
