Caring messages added no measurable benefit to good follow-up after suicidality

The edition in brief

The CARE trial randomised 709 American Indian and Alaska Native adults with active suicidality to culturally adapted Caring Contacts — brief, undemanding text messages or cards over 12 months — plus optimal available resources, or to those resources alone. Suicidal ideation roughly halved in both arms and the proportion with a past-year attempt fell from about 45% to about 15%, but there was no difference between groups. The authors suggest regression to the mean, the compassionate baseline contact, or the usual-care resources themselves may explain the shared improvement; 36% were lost to follow-up. A US trial of 126 unemployed job seekers found that six weeks of app-based cognitive behavioural exercises plus three video coaching sessions increased job-search behaviour, reduced depressive symptoms more than emailed advice, and was associated with more people finding work (68.3% vs 50.8%), though differences faded by follow-up. A meta-analysis of 14 small trials, mostly from one country, reported that each 30 mg/day of crocin, a saffron constituent, was associated with lower depression and anxiety scores, but heterogeneity was extreme (I² about 97%). The pearl is about making the first contact after a suicidal crisis count.