This is an inpatient clinical trial of a new form of transcranial magnetic stimulation with 10 treatments/day for 5 days, called SAINT. It is jointly funded by the NIH and a TMS company, MAGNUS. It is being done at 5 enrolling sites in the US, with total sampe of 100. Depressed and suicidal inpatients will have an MRI scan, then 5 days of treatment, and then a followup MRI scan. Outcome measures are depression and suicide ratings, as well as MRI changes. It is randomized and double blind, so some patients will not be getting active TMS. Importantly this is an adjunctive treatment study on top of all routine clinical treatments.

This NIH sponsored research study with an industry collaborator (MAGNUS) is being conducted at up to five study centers throughout the United States. MUSC is the lead site. Up to 100 inpatient participants with a diagnosis of MDD will be enrolled in this double-blind, randomized, study. There are 2 study arms: active SAINT® and sham "fake" SAINT®. Patients will be randomly assigned, like the flip of a coin (50:50 chance), to active or sham SAINT®.

The purpose of this study is to compare the effectiveness of two psychological treatments for the reduction of suicide attempts among U.S. military personnel and veterans, and to identify the reasons why and how these treatments work.

Specifically, this study is looking at the efficacy of two interventions. The first intervention is Present Centered Therapy (PCT). This treatment has been shown to reduce depression, PTSD symptoms, and suicidal thoughts. The second intervention is Brief Cognitive Behavioral Therapy (BCBT). This treatment has also been shown to reduce depression, PTSD symptoms, and suicidal thoughts.

Both treatments involve a total of 12-16 sessions scheduled once or twice each week. Patients who have received either treatment have reported significant reductions in suicidal thoughts and psychological symptoms. These two treatments differ from each other with respect to the specific procedures and techniques used. The purpose of this study is to determine if one treatment works better than the other, or if they are equal to each other with respect to outcomes.

This study is only open to Veterans at the Ralph H. Johnson VA Health Care System and CBOCs or active duty military personnel in the Charleston, SC and Savannah, GA areas.