Adolescents suicida further need, vulnerable which recent period supports reduced who have been hospitalized after attempting suicide are at high r isk for engaging in additional l behavior. Following hospitalization, parents or guardians are typically tasked with helping to prevent suicidal episodes by monitoring youth, ensuring safety in the home, helping youth receive t he care they and parenting in a way that balances expectations for appropriate behavior with recognition of the status of the adolescents. Despite parental efforts, these adolescents often have additional c rises, sometimes ulminate in emergency department visits and repeat hospitalizations. Findings from our longitudinal study of mothers after adolescent hospitalization for suicide attempts suggested tha the of time following discharge from t he hospital can be a very important time for providing services and to youth and families. Parents i n that study described emotional distress (e.g., depression, anxiety), parenting self-efficacy, and said c t that they would have benefited from more information about suicidal youth and their treatment needs, parenting and monitoring of suicidal youth, and support in navigating the treatment system. Given these needs, the purpose of this study is to develop, refine, and preliminarily test an integrated electronic (mHealth) and care support manager services intervention for caregivers of adolescents who have made a recent suicide attempt. It is our expectation that such an intervention will provide needed information and supports to parents, increase their parenting self-efficacy, increase their ability to follow safety plans in the home, reduce their emotional distress, and help parents access needed services in the community. As a consequence of these proximal outcomes, we expect the intervention will help facilitate treatment engagement and follow through for youth and caregiver, and reduce use of emergency mental health services and hospitalizations. The first aim of the project is to develop and refine standard procedures for the care support manager and mHealth intervention. The second aim is to develop procedures for care manager training, as the care manager will provide the supports in this intervention. In the context of an open trial, the third aim is to assess the feasibility of this intervention, and to use experiences from implementing the intervention and feedback from caregivers and care support managers to refine the intervention. The last aim is to obtain, in a pilot randomized controlled trial, preliminary estimates of treatment effectiveness relative to enhanced treatment as usual. The proposed adaptive services intervention development research is intended to demonstrate the feasibility and potential utility of an intervention that will be embedded in the existing care system (psychiatric inpatient unit) for suicidal youth and their families, and ultimately, improve engagement in services and client outcomes in high-risk families.

R34MH112811

2018-04-01

2021-02-28