Brief cognitive behavioral therapy may reduce suicidal behaviors in US Army soldiers while decreasing costs

Using brief cognitive-behavioral therapy (CBT) to reduce suicide attempts among at-risk soldiers would likely save the Department of Defense money in addition to being more effective than the current treatments, according to new research published in JAMA Psychiatry.

“We thought it was important to undertake this study because cost-effectiveness analysis provides decision-makers with vital information when weighing whether to implement a new healthcare intervention,” explained study author Sam L. Bernecker, a postdoctoral fellow at Harvard Medical School.

“The specialized treatment that we investigated is one of the few interventions for servicemembers with suicidal thoughts and behaviors that has been rigorously tested in a randomized controlled trial.”

A previous study of 152 Army soldiers who had either attempted suicide or had been determined to be at high risk for suicide found that brief CBT treatment significantly reduced soldiers’ likelihood of future suicide attempts.

Soldiers who completed about 12 CBT sessions plus the usual treatment (such as group therapy and medication) were 60 percent less likely to make a suicide attempt during a 2-year follow-up than those only receiving the usual treatment.

“It worked: soldiers who received that treatment in the trial were far less likely to attempted suicide during the 2-year follow-up period. Because it appeared so promising, we thought it would be useful to take the next step of providing the DoD with information about cost-effectiveness,” Bernecker said.

In their new study, the researcher estimated that brief CBT treatment could avert approximately 23 to 25 more suicide attempts and 1 to 3 more suicide deaths per 100 patients treated than treatment as usual.

The DoD could save from $15,000 to $16,630 per patient, the researchers found.

“A treatment that focuses on providing severely suicidal patients with skills to deal with crises is not only effective in servicemembers, but also probably reduces costs to the DoD,” Bernecker told PsyPost.

However, “it’s unclear whether these results would generalize to civilians or other healthcare settings,” Bernecker added.

“There’s also some uncertainty in our findings because we relied on a single clinical trial for information about the treatment’s effects on U.S. Army soldiers; fortunately, a second trial of this treatment is ongoing, which should give us a sense of the reliability of the results.”

The study, “Economic Evaluation of Brief Cognitive Behavioral Therapy vs Treatment as Usual for Suicidal US Army Soldiers“, was authored by Samantha L. Bernecker, Kelly L. Zuromski, Justin C. Curry, Jane J. Kim, Peter M. Gutierrez,Thomas E. Joiner, Ronald C. Kessler,Matthew K. Nock,M. David Rudd, and Craig J. Bryan.