title: Investigating the feasibility and acceptability of a cognitive behavioural suicide prevention therapy for people in acute psychiatric wards (the 'INSITE' trial): study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Suicide is a major cause of preventable death, and suicidal behaviour is prevalent in acute psychiatric wards. People admitted to acute psychiatric wards often experience repeated episodes of suicidal behaviour, causing great distress and heavy use of NHS services. There is little research investigating effective psychological treatments for suicidal patients in inpatient settings although previous research has found support for psychological therapies which specifically target suicidal behaviour. This paper describes the protocol of a single blind RCT to investigate the acceptability and feasibility of a cognitive behavioural intervention targeting suicidality (CBSP) for suicidal people in acute psychiatric wards.
  
  
  METHODS
  A single blind RCT comparing treatment as usual (TAU) to TAU plus Cognitive Behavioural Suicide Prevention (CBSP) therapy (TAU + CBSP). Sixty participants (aged 18-65 years) who are suicidal, or have been within the past 3 months, will be recruited from NHS trusts in the North West of England. Our primary objective is to determine whether CBSP is feasible, acceptable and efficacious when compared to patients who receive TAU alone. Secondary aims are the impact of CBSP on suicidal thinking, behaviours, functioning, quality of life, service use and psychological factors associated with suicide. Assessments take place at baseline, 6 weeks and 6 months (end of treatment). The analysis will report on the feasibility and acceptability of CBSP. Qualitative data from staff and service users will inform feasibility and acceptability data.
  
  
  CONCLUSIONS
  Psychiatric inpatients are a high-risk group and the use of psychological therapies in these settings is rare and requires evaluation. This study is essential to investigate the unique contextual challenges involved in delivering psychological therapy to suicidal inpatients and to identify any necessary modifications required within inpatient settings. The findings will inform a larger, definitive trial.
  
  
  BACKGROUND
  15 March 2012, PB-PG-1111-26026, NIHR ISRCTN17890126 .
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. gillian.haddock@manchester.ac.uk.
authors: Gillian
authors: G
authors: Haddock
authors: Centre for Health Economics, Institute of Population Health, Manchester University, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK. linda.davies@manchester.ac.uk.
authors: Linda
authors: L
authors: Davies
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. emma.evans@manchester.ac.uk.|Manchester Mental Health and Social Care NHS Trust, Manchester, UK. emma.evans@manchester.ac.uk.
authors: Emma
authors: E
authors: Evans
authors: Centre for Biostatistics, Institute of Population Health, Manchester University, 1.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK. richard.emsley@manchester.ac.uk.
authors: Richard
authors: R
authors: Emsley
authors: School of Psychological Sciences, Manchester University, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK. patricia.a.gooding@manchester.ac.uk.
authors: Patricia
authors: P
authors: Gooding
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. lisa.heaney@manchester.ac.uk.
authors: Lisa
authors: L
authors: Heaney
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. sarah.jones-5@manchester.ac.uk.
authors: Sarah
authors: S
authors: Jones
authors: Lancashire Care NHS Foundation Trust, Early Intervention Service, Accrington, UK. james.kelly@lancashirecare.nhs.uk.
authors: James
authors: J
authors: Kelly
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. ailsa.munro@manchester.ac.uk.
authors: Ailsa
authors: A
authors: Munro
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. sarah.peters@manchester.ac.uk.
authors: Sarah
authors: S
authors: Peters
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. daniel.pratt@manchester.ac.uk.
authors: Daniel
authors: D
authors: Pratt
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. nicholas.tarrier@manchester.ac.uk.
authors: Nicholas
authors: N
authors: Tarrier
authors: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, Centre for Mental Health and Safety, Manchester University, 2nd Floor, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK. kirsten.windfuhr@manchester.ac.uk.
authors: Kirsten
authors: K
authors: Windfuhr
authors: School of Psychological Sciences, Manchester University, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK. yvonne.awenat@manchester.ac.uk.
authors: Yvonne
authors: Y
authors: Awenat
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003627:Data Interpretation, Statistical; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D018579:Patient Selection; D016037:Single-Blind Method; D000092864:Suicide Prevention