Many of us have been riveted by the news reports of the global search for a COVID-19 vaccine. As researchers who spend countless hours, months, and years on rigorous randomized controlled trials (RCTs), it is satisfying to hear RCTs described as the “gold standard” for establishing the causal impact of a treatment’s effectiveness – whether it’s to develop a treatment for COVID-19 or suicide risk.
Unfortunately, for those who do RCTs with suicidal risk that require close contact with patients, years of development and/or data collection are suddenly thrust into a state of uncertainty because of the pandemic. For example, much of my professional life is focused on RCTs of CAMS with different samples of suicidal patients and clinical settings. To this end, three separate CAMS-related RCTs are either interrupted or in a state of limbo because of the pandemic.
At the San Diego VA Medical Center, an RCT comparing the CAMS intervention to Safety Plans and caring telephone contact was about one-third complete. In late February/early March, as the coronavirus spread exponentially in the US, we rather suddenly had to interrupt the RCT as stay-at-home orders were issued across the country and veterans could no longer come to the medical center for treatments.
Another study related to applying elements of CAMS assessment and intervention within a tablet application for suicidal patients seen in emergency departments (EDs) was going full strength at the Mayo Clinic, when suddenly COVID-19 patients overran the ED and the data collection for the study was suspended – once again, about a third into target sample recruitment.
Finally, a very large multisite RCT scheduled to start in the fall at four universities to recruit 700 suicidal college students is now in limbo, since no one knows if we will see students back on campus come September.
While the pandemic has turned all our lives upside down both personally and professionally, for the suicide treatment researcher, there is a unique confluence of issues at hand related to COVID-19:
- Do we simply wait to do our studies until there is a vaccine, and how long will that delay be? One year, two years…more?
- Do we wait and hope that a non-vaccine-reliant solution emerges sooner rather than later?
- Do we switch to using telehealthcare vs. in-office care, presenting a potential confound to the proposed study methodology?
- With the potential of COVID-19 increasing the suicide risk, do we publish what we have, with less-than-optimal samples, to share the most recent research and be a part of the solution to reduce the suicide rate?
While the need to figure out the impact of the pandemic on our research is obvious, there is another point that has been made clear to me over the past several months: While we do not yet know how to treat this deadly coronavirus, we do know how to treat suicide risk. We simply must stop the prospect of the pandemic leading to a double tragedy – losing our loved ones to this horrible virus and losing loved ones to suicide.
If you’re reading this blog, you likely treat suicidal patients. I know it’s not always an easy path, but it is incredibly important and courageous work you do. If you haven’t already, I encourage you to review some of our free telepsychology resources on the website, so that you can continue your work throughout the pandemic: