Suicide is the second leading cause of death among adolescents in the US. Adolescents hospitalized for SI or SA are at risk for future SAs and early mortality; rates of death by suicide may be as high as 10% by 15 years post discharge. Despite these known risks, many suicidal adolescents do not obtain treatment after hospital discharge because there are not enough providers trained to deliver effective suicide prevention. Thus, there is an urgent need to develop scalable suicide prevention methods. Youth-Nominated Support Team (YST) is a 3- month program that pairs adolescents, who are being discharged from a healthcare facility after a suicide attempt, with adults (known as support adults) whom the patient selects to become their support network. YST decreases the likelihood of suicide attempts by training the support adults to encourage youth to adhere to treatment and make positive behavioral choices. While effective, YST is not readily scalable as it requires significant time commitment from mental health professionals (known as YST intervention specialists) and necessitates engagement and coordination from multiple personnel. To mitigate these limitations, we propose to build eYST, which will streamline YST's operational processes by 1) digitizing components of the psychoeducational training delivered to youth, parents and support adults and 2) reducing administrative burden on the YST specialists by automating repetitive tasks. Thus, this study has two primary aims: 1) develop eYST, a platform to support more efficient implementation of YST; and 2) test the feasibility and acceptability of eYST in a single-group, open-label trial. An exploratory aim is to examine the range and variability of outcomes associated with YST, including suicidal thoughts and behaviors, healthcare service utilization, and perception of adult social support in a pre/post design of eYST with adolescent patients being discharged from a psychiatric hospital. To develop eYST, we will use implementation science frameworks to understand the needs of stakeholders and system-level. Metrics to be used to measure eYST's acceptability and feasibility include the sum average score of the System Usability Score scale, percentage of nominated adults agreeing to participate, percentage of youth having 3 or more adults participating in the psychoeducation, etc. Twenty youth, 40 parents/guardians, and 60 supporting adults will be enrolled in the trial. Phase I results will be used to inform preparation of a future SBIR Phase II grant. Commercialization of eYST will occur through health plans. The long-term goal is to markedly increase access to a proven intervention and deliver a digital and scalable solution, eYST, that can be easily integrated with the existing infrastructure of behavioral health programs, ultimately aiding in reducing the likelihood of suicide among youth.
Public Health Relevance Statement: PROJECT NARRATIVE Suicide is the second leading cause of death among youth in the US; however, only a limited number of suicide prevention interventions have been shown to decrease the likelihood of sucide attempt (the strongest predictor of suicide) in youth. Therefore, Oui Therapeutics seeks to digitize The Youth Nominated Support Team (YST): an effective and proven suicide prevention intervention that decreases the likelihood of suicide attempt in youth. This intervention will be nationally scalable and accessible to suicidal youth, and will ultimately lead to a reduction in their suicide rate.
Project Terms: Hospitalized Adolescent; Adult; 21+ years old; Adult Human; adulthood; Aftercare; After Care; After-Treatment; post treatment; Age; ages; Automation; Behavior Therapy; Behavior Conditioning Therapy; Behavior Modification; Behavior Treatment; Behavioral Conditioning Therapy; Behavioral Modification; Behavioral Therapy; Behavioral Treatment; Conditioning Therapy; behavior intervention; behavioral intervention; Cause of Death; Child; 0-11 years old; Child Youth; Children (0-21); youngster; Clinical Trials; Future; Goals; Grant; Health care facility; Health Facilities; Healthcare Facility; care facilities; Health Services; Health Services Accessibility; Access to Care; access to health services; access to services; access to treatment; accessibility to health services; availability of services; care access; health service access; health services availability; service availability; treatment access; Hospitals; Psychiatric Hospitals; Mental Hospitals; Mental Institutions; mental health facility; Interview; Lead; Pb element; heavy metal Pb; heavy metal lead; Medicine; Mental Health; Mental Hygiene; Psychological Health; Methods; Michigan; Morbidity - disease rate; Morbidity; mortality; Persons; Parents; Patients; Perception; pilot study; Pilot Projects; Publishing; Investigators; Researchers; Research Personnel; Risk; social support network; Social support; fatal attempt; fatal suicide; intent to die; suicidality; Suicide; non fatal attempt; nonfatal attempt; suicidal attempt; Suicide attempt; Supervision; Testing; Time; Training Support; United States; Measures; Businesses; Healthcare; health care; Specialist; Youth; Youth 10-21; Caring; Social Network; quality assurance; Suicide prevention; Suicide precaution; prevent suicidality; prevent suicide; suicidality prevention; suicide intervention; Acute; Clinical; Phase; Adolescent; Adolescent Youth; juvenile; juvenile human; Death Rate; Training; Health Care Utilization; health care service use; healthcare service use; healthcare service utilization; healthcare utilization; health care service utilization; Research Activity; Therapeutic; Knowledge; programs; Suicidal thoughts; suicidal ideation; suicidal thinking; suicide ideation; thoughts about suicide; Feeling suicidal; System; Country; Best Practice Analysis; Benchmarking; Visit; suicide risk; suicidal risk; success; Participant; member; Care Manager; Case Management Nurse; Case Manager; Manpower; personnel; Human Resources; Modeling; behavioral health; psychoeducation; Intervention Strategies; interventional strategy; Intervention; Provider; telehealth; Address; Data; Preventative intervention; intervention for prevention; prevention intervention; preventional intervention strategy; preventive intervention; Sum; Enrollment; enroll; Small Business Innovation Research Grant; SBIR; Small Business Innovation Research; Clinical Trials Cooperative Group; Clinical Cooperative Groups; Clinical Trial Groups; Preparation; Process; Behavioral; Health Professional; Health Care Professional; Healthcare professional; open label; open label study; suicidal behavior; suicide behavior; suicide rate; digital; design; designing; suicidal morbidity; suicide death; suicide morbidity; Outcome; scale up; suicidal patient; suicide patient; suicidal adolescent; suicidal youth; usability; psychoeducational; commercialization; high risk; adolescent patient; support network; improved outcome; recruit; health plan; health plans; Infrastructure; implementation framework; implementation research framework; implementation science framework; acceptability and feasibility; feasibility testing; pilot test
