Therapeutic model for youth suicide prevention 'first step' toward short-term intervention
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A new therapeutic model may be an alternative to lengthy hospital stays for adolescents who are acutely suicidal, according to study results published in Child and Adolescent Mental Health.
“The study provides promising findings that warrant further investigation of a brief, intensive crisis intervention model as an alternative to inpatient care for youth at risk for suicide,” Sandra M. McBee-Strayer, PhD, of The Research Institute at Nationwide Children’s Hospital in Ohio, told Healio Psychiatry. “The significant reductions in suicidal ideation and improvements in functioning reported sets the stage for a randomized controlled trial investigating intensive crisis intervention as a viable treatment option for youth at risk for suicide.”
According to McBee-Strayer and colleagues, although adolescent suicide remains a global major public health concern, research is sparse regarding the effectiveness of interventions that target youth suicide risk. In the present study, the researchers assessed the clinical outcomes, feasibility and acceptability of the Intensive Crisis Intervention (ICI) — a family-centered, cognitive-behavioral treatment that provides an alternative to longer inpatient care, they wrote. They did so over a 2-year period with 50 adolescents, most of whom were female (86%) and Caucasian (78%), with a mean age of 15.1 years. All participants were admitted to an intensive crisis stabilization unit for treatment of suicidal attempts and/or ideation.
Of the study participants, 88% provided follow-up data. The researchers reported that the mean Suicidal Ideation Questionnaire-Junior score at 3 months improved 34.2 points relative to baseline for an effect size of 2.2 (P < .0001). They observed significant improvements in functioning, readiness for care transition and consumer satisfaction upon discharge.
“We are hopeful about these promising findings as an important first step in investigating a short-term crisis intervention alternative to longer inpatient hospitalization for youth at risk for suicide,” McBee-Strayer said. – by Joe Gramigna
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Jonathan Singer, PhD, LCSW
The ICI described in the article has all the components of effective treatment: It is grounded in theory, requires family participation and addresses several key issues that are common in youth suicidal crises. The treatment reminded me of the outpatient crisis services I provided to suicidal youth and their families in the late 1990s. We would spend several hours per day with families in the office or their homes providing intensive individual and family therapy, all in the service of avoiding hospitalization. The most important take-home for me about this article is that the average length of stay for ICI was 3 days. According to Levine et al (2005), youth hospitalized after a suicide attempt had an average length of stay of 2 days before being discharged to home. Given that youth spent 50% more time in ICI than in typical hospitalizations, ICI’s model should become the norm in hospital-based treatment for suicidal youth as it provides intensive family therapy in a theoretically grounded intervention, addressing many of the key issues that youth face in a suicidal crisis.
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