A Digital Psychoeducational Social Network Intervention for Suicidal Adolescents

ABSTRACT 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.