Youth-Nominated Support Team Intervention for Suicidal Adolescents

This study will attempt to improve treatment adherence and reduce suicide risk among adolescents who are at risk for attempting suicide.

Despite substantial knowledge about adolescent suicide risk factors, few studies have been conducted to identify effective interventions for suicidal adolescents. Youth-Nominated Support Team (YST) is an intervention designed to help suicidal adolescents after hospitalization. It is a psychoeducational social network intervention that targets poor treatment adherence and difficulties with social support. YST is designed to be a supplement to traditional or usual treatments. Participants are randomly assigned to receive either treatment as usual (TAU) or TAU plus YST for 3 months. Adolescents who receive TAU plus YST nominate three or four adults from their family, school, and community settings to function as support persons. The support persons participate in a psychoeducation session that focuses on the adolescent's psychiatric disorder(s), individualized treatment plan, importance of treatment adherence, and suicide risk factors. They also maintain regular contact with the adolescent to support treatment adherence and progress toward treatment goals. Adolescents have assessments at 6 weeks, 3 months, 6 months, and 12 months. Internalizing behavior problems, perceived social support, treatment adherence, adaptive functioning, severity of depression and anxiety, severity and frequency of suicidal thoughts, and suicide attempts are assessed.

Adolescents nominate up to 4 caring adults from family, school, community settings. These adults participate in psychoeducation sessions regarding adolescent's treatment plan and support needs. They maintain regular, supportive contact with the adolescent for 3 months -- with ongoing consultation and support check-ins from study clinical staff.

Adolescents in this condition receive study assessments and risk management services (at time of assessments) only

Inclusion Criteria: Hospitalization in a participating psychiatric facility Suicidal ideation, intent, or attempt Exclusion Criteria: Severe physical or cognitive impairment that makes informed consent, nominations, or participation in assessments impossible

Witt KG, Hetrick SE, Rajaram G, Hazell P, Taylor Salisbury TL, Townsend E, Hawton K. Interventions for self-harm in children and adolescents. Cochrane Database Syst Rev. 2021 Mar 7;3(3):CD013667. doi: 10.1002/14651858.CD013667.pub2.

King CA, Arango A, Kramer A, Busby D, Czyz E, Foster CE, Gillespie BW; YST Study Team. Association of the Youth-Nominated Support Team Intervention for Suicidal Adolescents With 11- to 14-Year Mortality Outcomes: Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry. 2019 May 1;76(5):492-498. doi: 10.1001/jamapsychiatry.2018.4358.