Intensive Crisis Intervention for teens with suicidal thoughts or behaviors

Intensive Crisis Intervention (ICI) for Adolescent Suicidal Behavior

This project will try a brief, family-focused Intensive Crisis Intervention to see if it helps 12–17-year-olds with suicidal thoughts or recent attempts reduce suicidal behavior and avoid inpatient psychiatric care.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 213 (estimated)
• Ages: 12 Years to 17 Years
• Sex: All
• Sponsor: Nationwide Children's Hospital (Academic / other)
• Locations: 1 site (Columbus, Ohio)
• Trial ID: NCT06476886 on ClinicalTrials.gov

What this trial studies

This project refines and pilots Intensive Crisis Intervention (ICI), a brief treatment that blends family therapy/parent training, cognitive behavioral therapy, and motivational interviewing to target family functioning and reduce adolescent suicidal behavior. In Year 1 the team will develop a treatment manual, training and supervision protocols, and data collection procedures, then pilot ICI with about 20 adolescents, 20 parents, and 16 providers. After refinement, 60 youths aged 12–17 presenting with suicidal ideation or behavior and eligible for both the Youth Crisis Stabilization Unit (YCSU) and an adolescent psychiatric inpatient unit (APIU) will be randomized 1:1 to receive ICI in the YCSU (n=30) or standard inpatient care in the APIU (n=30). A mixed-methods approach will examine feasibility, acceptability, implementation processes, and preliminary clinical and service-use outcomes at Nationwide Children's Hospital.

Who should consider this trial

Good fit: Adolescents aged 12 years 0 months to 17 years 6 months presenting with suicidal ideation or behavior who are clinically eligible for both the YCSU and APIU, score ≥23 on the CHRT-SR, and have a legal guardian able to consent are the intended participants.

Not a fit: Patients who are actively psychotic, unable to understand study procedures (for example due to significant intellectual disability), unable to read or speak English sufficiently, or not eligible for admission to both care settings are unlikely to benefit from this intervention as tested.

Why it matters

Potential benefit: If successful, ICI could offer a shorter, family-centered alternative that reduces inpatient admissions and improves family functioning and suicidal outcomes for adolescents.

How similar studies have performed: Components of ICI such as family therapy, cognitive behavioral therapy, and motivational interviewing have shown promise for adolescent suicidality, but the combined brief ICI package and its implementation in a crisis stabilization unit is novel and not yet fully tested.

Eligibility criteria

Inclusion Criteria:

1. Youth between the ages of 12 years 0 months and 17 years 6 months at time of consent
2. Present to the Nationwide Children's Hospital (NCH) Psychiatric Crisis Department (PCD) or NCH Psychiatry Consult Liaison (CL) Service with suicidal ideation and/or behavior as the primary referral
3. Be eligible for admission to both YCSU and APIU based on PCD or CL clinician's clinical judgement
4. Patient and legal guardian must be willing to be admitted to either YCSU or APIU
5. Youth obtains a score of ≥23 on the Concise Health Risk Tracking Self-Report (CHRT-SR)
6. Youth resides with a primary caretaker who has legal authority to consent for participation in research
7. Legal guardian must attend the PCD or CL evaluation

Exclusion Criteria:

1. Participants who are unable to understand study procedures (e.g., intellectual disability, actively psychotic)
2. Inability to speak or read English adequately to understand and complete study consent and procedures

YCSU clinicians, PCD staff, and NCH-BH leaders will be invited to participate based on their roles in the system-of-care.

Where this trial is running

Columbus, Ohio

• Nationwide Children's Hospital — Columbus, Ohio, United States (Recruiting)

Study contacts

• Principal investigator: Jennifer L Hughes — Nationwide Children's Hospital
• Study coordinator: Jennifer L Hughes

Conditions Suicide; Suicidal Ideation; Suicide, Attempted; Suicide and Self-harm; Suicide Threat