Adapting a Brief Suicide Intervention for Pediatric Primary Care: Enhancing Uptake and Impact

Suicide is a leading cause of death among adolescents in the United States and improving access to high quality just-in-time suicide interventions to reduce risk has important public health implications. Integrating such interventions into routinely accessed settings, such as pediatric primary care, holds promise; however, many clinicians in these settings fail to adequately screen or intervene in youth suicidal thoughts and behaviors, representing a key barrier to reducing suicide. The proposed study is a pre-post quasi-experimental pilot feasibility and preliminary efficacy trial of a suicide prevention intervention informed by evidence based interventions including the SAFETY-Acute suicide prevention intervention implemented in 3 pediatric primary care clinics.

This project aims to take an innovative, user-centered design approach to improve suicide prevention in primary care settings to support primary care management of adolescents with low to moderate risk suicidal thoughts and behaviors (STB), drawing on the evidence-based SAFETY-Acute (SAFETY-A; formerly known as Family Intervention for Suicide Prevention -aka FISP) intervention. In this trial, the investigators will conduct a pre-post quasi-experimental pilot feasibility and preliminary efficacy study of an adapted STB model of care compared to treatment as usual, with 3 primary care clinics. The trial will include 48 10-18-year-old patients with STB and their parents/caregivers. The investigators will assess acceptability and feasibility of the STB model of care, preliminary intervention impacts, and need for further adaptation.

Adolescent Inclusion Criteria: * adolescent between the ages of 10 and 18 years old * speaks fluent English * current or past low to moderate suicide risk (denies current plan with intent to kill self) Adolescent Exclusion Criteria: * high suicide risk (endorses current plan and intent) * does not speak fluent English * does not have a primary care provider Caregiver Inclusion Criteria: * has a child who meets inclusion criteria * Age 18 years or older Caregiver Exclusion Criteria: * does not have a child who meets inclusion criteria * does not speak English Provider Inclusion Criteria: * Age 18 years or older * works in primary care/outpatient healthcare setting