A 3-day intensive crisis intervention program for adolescents at Nationwide Children’s Hospital, Columbus, Ohio, resulted in significant reductions in suicidal ideation 3 months later. Researchers published results of their pilot study online in Child and Adolescent Mental Health.
“Many communities are searching for other options [than inpatient psychiatric hospitalization], and what we have found is that this model holds a lot of promise,” said study lead author Sandra M. McBee-Strayer, PhD, a research scientist in the Center for Suicide Prevention and Research at Nationwide Children’s Abigail Wexner Research Institute.
With funding from the Alcohol, Drug and Mental Health Board of Franklin County Ohio, mental health professionals and physicians from the Nationwide Children’s youth crisis stabilization unit developed the three-phase, family-centered model as an alternative to longer inpatient care for adolescents with suicidal ideation or behavior. The program centers on cognitive behavior therapy.
In the first phase, a psychiatrist and crisis clinician assess what led up to the crisis and develop a treatment plan. In the second phase, the patient participates in up to two family sessions and three individual sessions daily to learn healthy responses to stress. The third phase begins when the treatment team and family agree the patient can safely return home, and includes safety planning and links with community care.
The 3 phases are designed to occur over 3 days.
“We know this will not be enough time to ‘solve’ all of a young person’s issues,” said study coauthor Ericka Bruns, LPCC-S, director of crisis services at Nationwide Children’s. “But we can work to help the patient and family understand the crisis, and help build coping mechanisms. The family involvement is so important because communication in the home and learning about the signs of suicidality is an important part of safety planning.”
The pilot study included 50 adolescents admitted to the youth crisis stabilization unit for suicidal ideation or behavior. Their average score on the Suicidal Ideation Questionnaire-Junior (SIQ-Jr).was 54.3 (a score of 31 or greater was required for inclusion in the study). More than half of participants had attempted suicide.
One month after undergoing intensive crisis intervention, the average score on the SIQ-Jr. had dropped to 20.9. Three months after participation, the average score was 20.1—however, 4 participants did report a suicide attempt. According to researchers, the rate is in line with other suicidality treatment studies, and the stage is now set for a larger randomized controlled trial to further examine efficacy of the treatment.
McBee-Strayer SM, Thomas GV, Bruns EM, Heck KM, Alexy ER, Bridge JA. Intensive crisis intervention for adolescent suicidal ideation and behavior – an open trial. Child and Adolescent Mental Health. 2019 July 1;[Epub ahead of print].