Can problem-solving therapy save older veterans from suicide?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * \>= 55 years old * SI (past month) on the C-SSRS * No SI or imminent risk (will be excluded) * Eligibility now includes non-specific active suicidal thoughts to active SI with some planning (on C-SSRS item 3: "Have you been thinking about how you might do this") and/or some intent to act (on C-SSRS item 4: "Have you had these thoughts and had some intention of acting on them?") provided that those endorsing item 4 have an established relationship with a psychiatrist aware of this intent level (who is not also performing psychotherapy) * Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded * Presence of DSM-5 depressive disorder or anxiety disorder, specified or unspecified, or PTSD or subthreshold PTSD. * No diagnosis of dementia; evidence that cognitive impairment is not indicative of possible dementia based on a negative cognitive telephone screen (\<10 errors on the Blessed cognitive screen) * No diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible) * No history of head injury past 12 months * No severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction * AUDIT Total score \<15 for men or \<13 for women (no current alcohol use disorder) * No substance use disorder of any type for illicit substances, no moderate or severe substance use disorder for cannabis/marijuana - on the MINI. * No prominent homicidal ideation * English language proficiency to engage in treatment * Sensory abilities sufficiently intact to engage in assessment and treatment * Not currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups. * No current prescription for anti-psychotics if prescribed for a psychotic disorder * Anti-psychotics for depression without psychosis are eligible * Psychotropic medications (e.g., SSRIs) are also eligible Exclusion Criteria: * \< 55 years old * No SI (past month) or imminent risk on the C-SSRS will be excluded. Those endorsing C-SSRS item 5: "Do you intend to carry out this plan?" would be considered at imminent risk and excluded * No DSM-5 depressive disorder or anxiety disorder, or PTSD or subthreshold PTSD * Diagnosis of dementia; evidence that cognitive impairment is indicative of possible dementia based on a positive cognitive telephone screen (\>=10 errors on the Blessed cognitive screen) * Diagnosis on MINI or medical record for psychotic symptoms or disorders, bipolar disorder, or severe OCD (mild or moderate OCD will be eligible) * History of head injury past 12 months * Severe or unstable chronic medical illness or other severe or unstable respiratory, cardiovascular, neurologic, hepatic, hematopoietic, gastrointestinal or metabolic dysfunction * AUDIT Total score \>14 for men or \>12 for women (no current alcohol use disorder) * Substance use disorder of any type for illicit substances, moderate or severe substance use disorder for cannabis/marijuana - on the MINI. * Prominent homicidal ideation * Lacking English language proficiency to engage in treatment * Sensory abilities not sufficiently intact to engage in assessment and treatment * Currently enrolled in individual psychotherapy for a mental health issue. Participants who are receiving mental health care are eligible if their current care includes treatment from a psychiatrist, supportive therapy, peer counseling or support, or participating in psychoeducational groups. * Current prescription for anti-psychotics if prescribed for a psychotic disorder, and not prescribed for depression without psychosis