Testing the Use of VA Peer Specialists to Prevent Veteran Suicide

Starting soon · Phase 3

Conditions studied: Suicide Risk

In brief

This study examines a novel way to prevent suicide among Veterans with serious mental illness (SMI). It will assess the efficacy of PREVAIL-VA, a 3-month intervention of 12, one-on-one sessions between a Peer Specialist (PS) and a Veteran that involve semi-structured conversations focused on hope, belongingness, support, and safety. PSs are Veterans with SMI trained to use their own experience and recovery to help other Veterans with SMI. PSs have improved mental health outcomes in other research, but this study would be the first to test their efficacy for suicide prevention in VHA. The project will compare outcomes of Veterans at risk for suicide receiving usual care, to PREVAIL-VA. This work is responsive to national calls for Veterans with SMI to receive support that is evidence-based, improves recovery (not just symptoms), and is tailored to individual needs. If successful, PREVAIL-VA could be adopted by the 1400 Peer Specialists employed in VA, greatly increasing the delivery of evidence-based services to Veterans at risk for suicide.

Key facts

Study ID: NCT07286383
Run by: VA Office of Research and Development
People needed: 306
Starts: 2026-07-01
Expected to finish: 2029-12-31
Last updated by the study team: 2026-04-09

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

There are two Inclusion criteria:
Moderate to high suicide risk according to one of the following occurring in the prior 3 months:
a completed Comprehensive Suicide Risk Evaluation (CSRE) indicating intermediate or high acute or chronic risk
a high-risk suicide PRF
a suicide attempt indicated on a Suicide Behavior or Overdose Report (SBOR)
a suicide safety plan completed in the past 6 months
AND
Current suicidal ideation according to the 9th item of the Patient health questionnaire (PHQ-9) > 0 at enrollment
While a positive 9th item usually precedes the CSRE, because the CSRE could have been administered in the 3 months prior to enrollment, the purpose of requiring a positive 9th item is to ensure more recent suicidal ideation.
It may be more difficult to show an intervention effect if the investigators enroll participants with no suicidal ideation at baseline.

You may not qualify if…

Inability to provide informed consent for any reason, including due to acute psychosis or mania, dementia, or active guardianship or durable power of attorney
These criteria will be determined according to medical record review and, if clarification needed, consultation with a treating provider.
The investigators will also screen for decision-making capacity using the Blessed Orientation, Memory, Concentration (BOMC) Test and a brief quiz about the study.
This quiz will involve an iterative process of querying the participants' understanding of consent information with a 10-item true/false test and providing feedback until an acceptable level of understanding is achieved (must get 100% correct after 3 tries to enroll).
Current or planned receipt of residential or intensive outpatient treatment
Plan to transfer or terminate care in the next 3 months
Homicidal ideation in the past 6 months or violent behavior in the past 12 months

Where it is running

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD — Baltimore, Maryland, United States
VA Ann Arbor Healthcare System, Ann Arbor, MI — Ann Arbor, Michigan, United States
VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA — Pittsburgh, Pennsylvania, United States

Full record on ClinicalTrials.gov

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