Within-person Assessment of Vulnerability to Suicidal Crises – WAVES

Traditional suicide risk assessments and interventions are usually based on so-called distal risk factors, which are risk factors that affect a person's risk for suicide but are stable and often long-term, such as psychiatric diagnoses and socioeconomic factors. Since these risk factors are temporally stable and often temporally distant from the attempt, they provide limited information about when a suicide attempt or suicidal crisis might actually occur. More research is needed regarding proximal risk factors and triggering factors to gain an understanding of how the suicidal process unfolds over time in individuals.

WAVES aims to improve knowledge about the suicidal process, more specifically its temporal dynamics and factors that can predict a suicidal crises over short times frames, and based on that knowledge develop a so-called "Just-In-Time Adaptive Intervention" (JITAI) that will be able to provide individualised support during suicidal crises in real time. The project is financed by a project grant from Forte with the amount of 5,995,000 SEK. WAVES runs from 2025–2029 and consists of three parts. 

• The first part includes in-depth interviews with individuals following a recent suicide attempt and crisis intervention personnel to gain a better understanding of different experiences of suicidal processes and the unfolding of events and behaviours in the hours before an attempt.
• The second part consists of mobile-based ecological momentary assessments (EMA) to collect high-resolution data on suicidal thoughts and intentions, as well as measure proximal risk factors. Participants are recruited from clinics in Region Stockholm and Region Jönköping as well as through helplines.
• The third part focuses on developing a mobile-based JITAI prototype that can provide immediate and personalised support during suicidal crises, with usability and acceptability evaluated through user testing and focus groups. 

The project will be conducted by researchers from Karolinska Institutet, Region Stockholm and Region Jönköping with extensive experience in suicide research, e-health technologies, and qualitative and quantitative methods. The project is supported by established collaborations with several stakeholders, including groups with lived experience, healthcare services, and emergency care. 

Findings from this project will provide a stronger fundemental understanding of individual-level processes leading up to a suicidial crisis. This knowledge can enable the development of more effective treatments and help identify individuals in moments of greatest risk, allowing them to receive timely, adequate, and personalised care.