BCBT is a well-established and efficacious treatment that is an extension of Cognitive Behavioral Therapy, a treatment that is widely implemented across VA health care systems.

The Longitudinal Interval Follow-up Evaluation (LIFE) is a timeline follow up interview measure that is administered at each of the assessment period. Participants are asked to describe their weekly suicidal thoughts and interviewers rate them on a 6-point Likert score ranging from 1 (not at all) to 6 (Extreme: has made preparations for a potentially serious suicide attempt). Data is then converted into the presence/absence of suicidal thoughts for each week of the follow up period. Data reported includes the mean number of weeks with reported suicidal thoughts (scores above 2).

The WHODAS 2.0 is a 36-question, self-administered questionnaire and generic assessment instrument for health and disability that covers six domains: Cognition (items 3 and 6), Mobility (items 1 and 7), Self-care (items 8 and 9), Getting Along (items 10 and 11), Life Activities (items 2 and 12), and Participation (items 4 and 5). Items are rated from "None," "Mild," "Moderate," "Severe," to "Extreme or cannot do," indicating difficulty over the past month. Total score is calculated by summing the item scores and then converted into a standardized score ranging from 0-100 with higher scores indicating greater disability.

The THI is an interview used to collect information about psychotherapy, hospitalizations, medical treatment, pharmacotherapy, and other means of psychologically-related help that a person may use. For this study we assessed the use of emergency services (emergency room visits for psychiatric reasons and hospitalizations for psychiatric reasons). Outcome was the number of times a participant used either emergency department or was hospitalized for mental health reasons.

The BSI is a 53-item self-report questionnaire developed by Derogatis and Melisarotos to measure psychological distress and assess the severity of symptom across the following dimensions: Somatization, Obsession-compulsion, interpersonal sensitivity , depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism. Items are rated on a 5-point Likert scale from 0-4. The Global severity index (GSI) was used and reported. GSI is a mean score for all items across all dimensions. Higher scores are indicative of greater psychological distress.

Sham Transcranial magnetic stimulation and brief cognitive behavioral therapy for suicide

Transcranial Magnetic Stimulation: Administration of rapidly fluctuating magnetic field, delivered over the dorsolateral prefrontal cortex.

Brief Cognitive Behavioral Therapy: BCBT is a well-established and efficacious treatment that is an extension of Cognitive Behavioral Therapy, a treatment that is widely implemented across VA health care systems.

Total of all reporting groups

Columbia Suicide Severity Rating Scale, ideation subscale for past two weeks. Scores range from 0-5 with higher scores representing more severe ideation.

Past two weeks number of reported suicide attempts collected via interview using the CSSRS suicide attempt item.

Past two week report on CSSRS interview. Count of number of suicide attempts, aborted attempts, and interrupted attempts.

Columbia Suicide Severity rating scale - Ideation subscale interview for lifetime most severe ideation on a scale of 0-5 with higher scores representing more severe ideation type.

Total lifetime number of interrupted, aborted, and actual attempts reported on the CSSRS interview.

THE BHS is a 20-item self-report measure designed to measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectation. Items are rated as true/false with true responses scored as 1 point. Scoring ranges from 0-20 with the following scale 0-3: normal, 4-8: mild hopelessness, 9-14: moderate hopelessness, and 15-20: severe hopelessness. Total scores were used for this study with higher scores indicative of greater hopelessness.

The BSI is a 53-item self-report questionnaire developed by Derogatis and Melisarotos to measure psychological distress and assess the severity of symptom across the following dimensions: Somatization, Obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism. Items are rated on a 5-point Likert scale from 0-4. The Global severity index (GSI) was used and reported. GSI is a mean score for all items across all dimensions. Higher scores are indicative of greater psychological distress.

The PCL-5 is a 20-item self report measure that assesses the DSM-5 symptoms of PTSD on a 5-point Likert scale (0-4). Total symptom severity score is obtained by summing the scores for all 20 items (0-80). Higher scores are indicative of greater severity.

The IDS-SR is a 30-item self report measure designed to assess the severity of depressive symptom over the last week. Items are scored using a 4-point Likert scale ranging from 0-3 with higher scores indicating greater severity. Total scores are calculated by summing responses to 28 items to obtain a total score ranging from 0-84.

The AUDIT is a 10-item screening tool developed by the World Health organization to assess alcohol consumption, behaviors, and problems associated with alcohol use. Individual items are rated on a 5-point Likert scale ranging from 0-4 with higher scores indicating more severe use. Range of possible scores is 0-40 with higher scores indicating more severe alcohol use/behaviors.

the DUDIT is an 11-item self report measure used to assess drug use and behaviors. Items 1-9 are scored on a 0-4 Likert scale and items 10-11 are scored 0, 2, 4. Total scores are the summation of all items and range from 0-44 with higher scores indicating greater severity of drug-use-related problems.

The WHO-DAS 2.0 36-self-version is a 36-item measure that assesses disability across six domains of functioning (cognition, mobility, self-care, getting along, life activities, and participation) in adults. Each item is rated on a 5-point likert scale from 0-4 with higher scores indicating greater disability. Total score is calculated by summing the item scores and then converted into a standardized score ranging from 0-100 with higher scores indicating greater disability.

The BSSI is a 19-item measure designed to assess the severity of suicidal thoughts in the week prior to evaluation. Each item is scored based on an ordinal scale from 0-2 and the total score range is 0-38 with higher scores indicating greater severity.

The MSI-BPD is a 10-item self-report tool designed to screen for Borderline Personality. Each item is rating on a dichotomous scale (1 for present, 0 for absent) and the total score ranges from 9-10 with higher scores indicative of greater likelihood for the presence of BPD. In this study, count is reported for the number of participants who scored >= 7 (the cutoff indicating presence of BPD symptoms).

The BSSI is a 21-item measure designed to assess the severity of suicidal thoughts in the week prior to evaluation. The first 5 items are screeners (wish to live, wish to die, and desire to attempt suicide), followed by 14 items to assess suicidal risk factors. The last 2 items capture previous suicide attempts.

Each item is scored based on an ordinal scale from 0-2 and the total score range is 0-38 with higher scores indicating greater severity.

The SSI total score is obtained by adding up the ratings (0-2) from the first 19 items.

Due to study attrition, the number of participants at follow-up differs from the number of participants at baseline. See participant flow for more details.

The Longitudinal Interval Follow-up Evaluation (LIFE) is a timeline follow up interview measure that is administered at each of the assessment period. Participants are asked to describe their weekly suicidal thoughts and interviewers rate them on a 6-point Likert score ranging from 1 (not at all) to 6 (Extreme: has made preparations for a potentially serious suicide attempt). Data is then converted into the presence/absence of suicidal thoughts for each week of the follow up period. Data reported includes the mean number of weeks with reported suicidal thoughts (scores above 2).

Due to study attrition, the number of participants at follow-up differs from the number of participants at baseline. See participant flow for more details.

The WHODAS 2.0 is a 36-question, self-administered questionnaire and generic assessment instrument for health and disability that covers six domains: Cognition (items 3 and 6), Mobility (items 1 and 7), Self-care (items 8 and 9), Getting Along (items 10 and 11), Life Activities (items 2 and 12), and Participation (items 4 and 5). Items are rated from "None," "Mild," "Moderate," "Severe," to "Extreme or cannot do," indicating difficulty over the past month. Total score is calculated by summing the item scores and then converted into a standardized score ranging from 0-100 with higher scores indicating greater disability.

Due to study attrition, the number of participants at follow-up differs from the number of participants at baseline. See participant flow for more details.

The THI is an interview used to collect information about psychotherapy, hospitalizations, medical treatment, pharmacotherapy, and other means of psychologically-related help that a person may use. For this study we assessed the use of emergency services (emergency room visits for psychiatric reasons and hospitalizations for psychiatric reasons). Outcome was the number of times a participant used either emergency department or was hospitalized for mental health reasons.

Due to study attrition, the number of participants at follow-up differs from the number of participants at baseline. See participant flow for more details.

The BSI is a 53-item self-report questionnaire developed by Derogatis and Melisarotos to measure psychological distress and assess the severity of symptom across the following dimensions: Somatization, Obsession-compulsion, interpersonal sensitivity , depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism. Items are rated on a 5-point Likert scale from 0-4. The Global severity index (GSI) was used and reported. GSI is a mean score for all items across all dimensions. Higher scores are indicative of greater psychological distress.

Due to study attrition, the number of participants at follow-up differs from the number of participants at baseline. See participant flow for more details.

Sham Transcranial magnetic stimulation and brief cognitive behavioral therapy for suicide

Sham Transcranial Magnetic Stimulation

Brief Cognitive Behavioral Therapy: BCBT is a well-established and efficacious treatment that is an extension of Cognitive Behavioral Therapy, a treatment that is widely implemented across VA health care systems.

Hospitalization due to surgery or other medical procedures

Psychiatric admission due to mental health symptoms (not SI/SB)

Visit to ER for psychiatric symptoms other than SI/SB