Preventing suicidal behavior in high-risk youth in emergency care settings

Preventing Suicidal Behavior With Diverse High-Risk Youth in Acute Care Settings

This study is testing two different short interventions to see which one better helps young people aged 12-19 who are at risk of suicide when they come to the emergency room.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 1000 (estimated)
• Ages: 12 Years to 24 Years
• Sex: All
• Sponsor: Johns Hopkins University (other)
• Locations: 6 sites (St. Petersburg, Florida and 5 other locations)
• Trial ID: NCT06151158 on ClinicalTrials.gov

What this trial studies

This study compares the effectiveness of two brief, evidence-based interventions aimed at preventing suicidal crises among youth aged 12-19 who present in emergency departments. The interventions include the Stanley Brown Safety Planning Intervention with Follow-up Contacts, which focuses on crisis de-escalation, and Interpersonal Psychotherapy for Adolescents Ultra Short Crisis Intervention, which addresses interpersonal issues contributing to suicidal thoughts. The research will take place in ethnically and racially diverse urban areas, including Philadelphia, Baltimore, and New York City, to ensure a broad representation of high-risk youth. The findings aim to inform future standards of care for suicidal adolescents in acute settings.

Who should consider this trial

Good fit: Ideal candidates are youth aged 12-19 who present to emergency departments with suicide-related concerns or who screen positive for serious suicidal ideation.

Not a fit: Patients with significant cognitive or developmental delays that hinder their ability to understand or use the interventions may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could significantly reduce suicidal behavior among high-risk youth by identifying effective interventions for acute care settings.

How similar studies have performed: Other studies have shown promise in using similar interventions for suicide prevention, but this specific approach in acute care settings is relatively novel.

Eligibility criteria

Inclusion Criteria:

* Suicide Risk During Acute Care Visit (At least one item in risk assessment is required; check all that apply): \_\_\_ Chief complaint of suicide-related concern (via Medical Record/Other), \_\_\_ Active suicidal ideation endorsed in past 1 month on validated suicide screener, \_\_\_ Suicidal behavior in the past 3 months on validated suicide screener, \_\_\_ Clinician indicated SI in past month or SA in past 3 months.
* Have access to a cellular phone with the ability to receive phone calls and text messages over the 12-month follow- up period
* Adolescent must be verbally fluent and can communicate, understand, and read in either English or Spanish
* Adolescent has been/will be discharged from a higher level of care (i.e. inpatient, day hospital, partial hospitalization program (PHP), or residential treatment program) and back in the community within 4 weeks of their acute care visit. \[Note: this criterion does not apply to all patients - select N/A if this is the case.

Exclusion Criteria:

* Significant cognitive or developmental delays that prevent understanding or using SPI+ or IPT-A-SCI (includes inability to communicate verbally)
* Altered mental status (acute psychosis, intoxication, or mania)
* Unable or unwilling to provide informed consent (adults), assent (minors), or permission (parents/caregivers)
* The services offered through the study are not in the best clinical interest of the patient (e.g., presenting problem requires a different level of care or treatment approach).

Where this trial is running

St. Petersburg, Florida and 5 other locations

• Johns Hopkins All Children's Hospital — St. Petersburg, Florida, United States (RECRUITING)
• Johns Hopkins University — Baltimore, Maryland, United States (RECRUITING)
• Columbia University Irving Medical Center (CUMC) — New York, New York, United States (RECRUITING)
• Weill-Cornell Medicine — New York, New York, United States (RECRUITING)
• University of North Carolina Medical Center — Chapel Hill, North Carolina, United States (RECRUITING)
• Childrens Hospital of Philadelphia — Philadelphia, Pennsylvania, United States (RECRUITING)

Study contacts

• Principal investigator: Holly C Wilcox, PhD — Johns Hopkins Bloomberg School of Public Health
• Study coordinator: Holly C Wilcox, PhD

Conditions: Suicide, Attempted, Suicide Ideation, Suicide, Suicide Prevention, Safety Planning Intervention, Ultra-Brief Crisis, Interpersonal Psychotherapy for Adolescents, Emergency Department