Effectiveness of a resilience-targeted intervention based on "I have, I am, I can" strategy on nursing home older adults' suicidal ideation: A randomized controlled trial

Background: Despite the potential for benefit, resilience remains an emergent area in late-life mental health care, and evidence of resilience intervention for suicide among nursing home residents is especially limited. This study aims to evaluate the effects of a resilience-targeted program based on the "I have, I am, and I can " strategy on suicidal ideation and related problems. Methods: From the 562 nursing home residents who were contacted, 68 with suicidal ideation were recruited and then randomly assigned to a resilience intervention group (eight-week resilience training; n = 34) or a wait-list control group (eight-week health education; n = 34). Self-reported suicidal ideation, and depression and anxiety symptoms as outcomes, and resilience as potential mediators were assessed at baseline, postintervention, and one-month follow-up. Results: Resilience training participants reported significant improvement in suicidal ideation (group x time interaction x(2)=12.564, p = 0.002) and depression symptoms (x(2)=9.441, p = 0.009) compared to wait-list control group participants. Changes in resilience mediated the intervention's effects on changes in suicidal ideation and depression symptoms.Limitations The observed effects must be considered preliminary due to the small sample size. Conclusions: The findings support the benefits of resilience training based on the "I have, I am, and I can " strategy in reducing suicidal ideation and suicide-related symptoms in nursing home older adults, and provide insight into possible mechanisms.