Mindfulness for Pain and Suicide

A Pilot Study on Mindfulness for Pain and Mental Health Outcomes

The proposed study will assess the feasibility and acceptability of a mindfulness-based intervention to reduce functional impairment from chronic pain and risk of suicide.

The investigators are seeking to develop a combined intervention, MBCT-S/P, to focus on both improving functioning and mitigating suicide risk in veterans with chronic pain. The investigators plan to test the new manual's feasibility and acceptability in a sample of veterans experiencing chronic pain and suicidal ideation. Participants will be randomized to either the MBCT-S/P condition (n=38) or the Education control condition (n=38) to assess additional aspects of study feasibility. The investigators also plan to assess a variety of clinical outcomes including suicidal ideation, pain interference in activities, and opioid use. Participants will complete questionnaires pre-treatment, and 1-, 3-, and 6-months post-treatment.

Inclusion Criteria:

• English-speaking veterans
• Ages 18 years and older
• Understand informed consent
• Report pain that occurs on at least half the days for six months or more
• Score at least a 4 on each item of the three items on a brief pain intensity and interference measure
• To meet the minimum threshold for suicide risk, veterans must meet at least one of the following: (1) endorse at least a 1 ("several days") on item 9 ("thoughts of you would be better off dead, or thoughts of hurting yourself in some way" in the past 2 weeks) of the Patient Health Questionnaire-9 (PHQ-9), (2) endorse at least "death ideation" in the last 3 months as measured by the Columbia Suicide Severity Rating Scale, or (3) report a suicide attempt in the last 6 months.

Exclusion Criteria:

• An active severe substance use disorder (SUD)
• Documented schizophrenia, active psychosis, or mania
• Upcoming surgeries
• Uncontrolled medical conditions
• Intent to carry out a plan for suicide.