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Journal Article

Citation

Goldstein TR, Kennard BD, Porta G, Miller AO, Aguilar K, Bigley K, Vaughn-Coaxum RA, McMakin DL, Douaihy A, Iyengar S, Biernesser CL, Zelazny J, Brent DA. J. Am. Acad. Child Adolesc. Psychiatry 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2024.06.008

PMID

39032815

Abstract

OBJECTIVE: We present results from a two-site, randomized clinical trial to assess efficacy of a brief intervention (As Safe As Possible; ASAP), a safety plan phone application (BRITE) and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations and suicidal events among adolescents.

METHOD: Adolescents (n= 240; ages 12-17) hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt were assigned to one of four treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone. Independent evaluators assessed suicidal ideation and behavior at 4, 12, and 24 weeks using the Columbia Suicide Severity Rating Scale (C-SSRS) and rehospitalization using the Child and Adolescent Services Assessment (CASA).

RESULTS: No group differences were found on primary outcomes, except ASAP participants were less likely to be rehospitalized over 6 months (15.6%, vs. 26.5%, p=0.046). Participants hospitalized for an attempt and assigned to BRITE had a lower rate of subsequent attempts (OR=0.16, p=.01) and greater time to attempt (HR=0.20, p=.02). ASAP+BRITE, while not statistically significant, was most consistently associated with a reduction in suicide attempts (60% reduction).

CONCLUSION: ASAP, BRITE, and their combination are equally effective at decreasing risk for suicidal events 6 months post-hospital discharge among suicidal adolescents; the ASAP intervention (with or without BRITE) was associated with lower rates of re-hospitalization. The BRITE app in youth hospitalized for suicide attempt had promising outcomes on future attempts.


Language: en

Keywords

adolescent; suicide; intervention; app

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