About this trial
The overall goal of this study is to respond to the urgent need for an effective suicide prevention strategy for Black youth by examining the effectiveness of a systems-level strategy to recognize and respond to suicide risk among Black adolescents who present to emergency departments (EDs). The proposed strategy, WeCare, combines combines three components: (1) universal screening using the Computerized Adaptive Screen for Suicidal Youth (CASSY), (2) a brief intervention designed for Black youth with elevated suicide risk in for ED settings, Connections for Safety (CFS), that combines safety planning and strategies to support linkage to outpatient mental health services, and (3) supportive text messages to youth and parent/caregivers for six weeks following the youth's ED visit. Study objectives are (1) to integrate input from multiple stakeholders to inform and facilitate WeCare implementation, and (2) to use a hybrid one effectiveness-implementation design to evaluate its effectiveness.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Adolescents aged 12-17 years and their parents or guardians, and adolescents 18-19 years who have the option for their parent or guardian to participate
Having a parent/caregiver present in the ED to consent or available to consent remotely (12-17 year olds, only)
Having a cellular phone with text messaging capacity
Adolescent able to speak English, and understand study questions
Disqualifiers
Adolescent is medically unstable
Adolescent present with severe cognitive impairment
Parents are not present in the ED, unable to consent remotely, and not able to give consent in either English, Spanish, French or Creole (12-17 year olds, only)
Adolescent does not have access to cellular phone
Trial design
Parallel
Treatments tested in this trial
WeCare
BehavioralWeCare combines two evidence-based strategies -- universal screening using the Computerized Adaptive Screen for Suicidal Youth and an adapted version of the SAFETY-ACUTE, which incorporates PI Lindsey's extensive work with Black youth, their families, and community stakeholders to develop culturally tailored strategies for addressing treatment barriers.
Treatment groups
Trial outcomes
Primary outcomes
Mental Health Outpatient Visits (Electronic Medical Record)
This measure assesses mental health service utilization from 50 patient care locations in New York City via electronic medical records.
Columbia-Suicide Severity Rating Scale
This measure is a semi structured interview to assess suicidal ideation and attempt This measure is a semi structured interview to assess suicidal ideation and attempt behavior (actual, interrupted, aborted suicide attempts; preparatory behavior).
Secondary outcomes
Attitudes Toward Psychological Help Scale
This measure assesses psychological factors, including stigma, perceived relevance of treatment, etc. that impact one's perceptions and attitudes about using formal mental health treatment services.
Barriers
This 5-item measure captures barriers to MH treatment participation identified in PI Lindsey's prior work with Black youth and families. A higher score indicates a perception of more barriers to treatment (Minimum score: 5; Maximum score: 15).
Caregiver Knowledge of Mental Health Services (Therapy Survey)
This measures expectations about treatment at a children's psychiatric clinic (caregiver).
ED STARS Mental Health Service Use
This measure assesses mental health service utilization, efforts to link to services, linkage, and engagement with outpatient MH services (caregiver).
Other outcomes
Self-Efficacy
This measure assesses adolescents' confidence in use of different coping behaviors (commonly incorporated in safety plans) when experiencing suicidal thoughts.
YRBS-Alcohol
This measure assesses alcohol use.
Drug Use Scale
This measure assesses adolescents' behaviors related to drug use.
YRBS-Physical Fights
This single item measures frequency of physical fighting with a higher score indicating more incifidenst of fighting.
Sponsors and contacts
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New York University
Lead sponsor
University of Michigan
Collaborator