A strong link exists between chronic illnesses and suicide: individuals who are diagnosed with a chronic condition have 363% higher odds of suicide. Up to 20% of individuals with a diagnosis of mental illness complete suicide. Research has also found that 90% of those who die by suicide experience mental illness. People considering suicide usually seek help: for example, 64% who attempt suicide visit a doctor within a month before their attempt.

Individuals wishing to enter a clinical research study, but express that they have had suicidal thoughts within the last 6-12 months, may not meet the study criteria. It is in these cases that the STARR 911Copyright Symbol Suicide Prevention Program comes into play.  STARR 911 connects suicidal individuals immediately to suicide prevention specialists and share potential life-saving information for others.


Clinical research facilities receive calls on a daily basis. For many individuals, contacting research sites about possible enrollment for a clinical study may be their first attempt to reach out for help. Therefore, research has an obligation to help make suicide prevention education and support a part of their first contact process and culture.

The STARR 911 Suicide Prevention Program builds the bridge between clinical research and suicide prevention. As part of the program, clinical research telephone operators and pre-screeners ask a series of questions of each caller to determine their suitability for studies on which they are working. If, during those calls, an individual indicates any suicidal thoughts, they may not fit the study criteria, at which time, the call script pivots to STARR 911.

STARR 911 clinical research telephone operators and pre-screeners are trained to respond to callers with suicidal ideation with support.  Using the simple STARR 911 script, the caller is asked a few simple questions to quickly assess the crises level of the suicidal thoughts. Then, based on the responses to each question, the operator provides either information on the Suicide Lifeline or given a “warm” hand off to a suicide prevention specialist.

STARR 911 gives research the opportunity to use its resources to impact suicide prevention. Research will gain credibility as being a part of the health care community and increase education to sites on suicide prevention resources.

Most important; the human factor. Statistics speak volumes for the need for the STARR 911 program. Linking individuals with support systems which meet their immediate needs is crucial for stability. This is a vital link in the chain of recovery.


If an individual is ineligible for participating in a clinical research study due to suicidal ideation, the screener will follow a script to determine whether the individual needs contact information to the Suicide Prevention Lifeline or the need to be given a warm handoff to a suicide prevention specialist. The process is simple and easy to follow.

Staff are able to be trained by watching a short video HERE (https://youtu.be/lHT4xv2-eqI)

Download the brochure to use for callers with suicidal ideation: BROCHURE/PROCEDURE

Download the Spanish version of the brochure to use for callers with suicidal ideation: STARR 911 Spanish brochure

We hope this will help guide those who are having thoughts of suicide to resources they need. Screeners are not expected to act as a suicide prevention specialist; experts are trained in these procedures. The American Foundation for Suicide Prevention Lifeline exists to help people, do not be afraid of doing a “warm handoff” if the caller is in need.


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