Attempted suicide short intervention program for older adults 65+ (ASSIP-OA): a study protocol for a multicentre randomised controlled trial

Older adults are underrepresented in suicide prevention research, even though suicide rates are higher in this age group (65+) than in any other age group in many countries worldwide. There are few clinical intervention studies that target this age group. A promising preventive intervention is the Attempted Suicide Short Intervention Program (ASSIP). Given differences in suicidal behaviour between older and younger adults, there is a need for suicide prevention intervention models that are adaptable to the heterogenic needs of older adults. This study protocol outlines the design of our upcoming study, which aims to evaluate a modified version of the Attempted Suicide Short Intervention Program (ASSIP) specifically adapted for older adults (65+), ASSIP for Older Adults (ASSIP-OA), as add-on to Treatment as Usual (TAU) and compared to TAU only. A multicentre two-group parallel randomised controlled trial will be conducted to compare TAU to ASSIP-OA (3–5 sessions) and standardized letters for 2 years as an add-on to treatment as usual. The trial, which is open labelled, will recruit 132 participants (65+) within psychiatric services in Sweden after a suicide attempt or hospitalisation for serious suicidal plans. The main modifications in comparison with the original ASSIP include (a) flexibility in treatment delivery (offering home visits, breaks and shorter/longer sessions as needed), (b) an additional session together with relatives or other support person(s), and (c) age-specific linguistic and content-wise adaptation of homework, letters, and case conceptualization. The primary outcome is a suicidal episode (fatal or non-fatal). Secondary outcomes include psychiatric symptoms, severity of suicidal ideation, coping style and quality of life. The trial also includes measures of feasibility, health-care utilization and negative effects of treatment. This study has the potential to inform the development and implementation of a more person-centred care for suicidal older adults. ClinicalTrials.gov: NCT06831942. Registered February 21, 2025, revised May 21, 2025.