This project outlines a comprehensive two-year initiative aimed at enhancing suicide care services in primary care settings. The project addresses a critical gap in the continuum of care by providing interim crisis support for at-risk patients who are waiting to be connected to specialty mental health. The main objectives of this project are to develop two innovative interventions intended to be delivered in a primary care setting: an adapted caring contacts protocol and a system to provide short-term, centralized remote monitoring of patient’s suicide risk. In designing these interventions, we intend to leverage technology such as digital/online platforms and remote monitoring systems that will support asynchronous patient check-ins. Finding innovative ways to offer support to patients in primary care settings where there is limited clinician time and typically an even more limited behavioral health workforce is imperative to creating a sustainable program. Therefore, our proposal intends to maximize the use of technology and focuses on self-guided and/or automated approaches.
This project uses a co-design approach to develop these interventions, where we will elicit input directly from patients and caregivers on the acceptability, feasibility, and appropriateness of these interventions. We hope this project will improve the timely support and management of suicide risk among primary care patients, ultimately enhancing services in outpatient settings while supporting the Least Restrictive Environment Framework, to enhance patient outcomes, reduce unnecessary referrals to overburdened emergency departments, and promote the overall well-being of patients and their families.
This project aims to partner with rural, urban, and suburban pediatric primary care practices in Western Washington to improve access and effectiveness of suicide prevention programs through adapting the SAFETY-A intervention for use in primary care settings. This project has the following aims: (1) assess needs of primary care staff, patients, and parents/caregivers for suicide prevention services in primary care, (2) iteratively design and refine a SAFETY-A based suicide prevention model of care prototype for primary care, (3) Pilot test the model of care, compared to treatment as usual, with 3 primary care clinics in rural, urban, and suburban settings.
Suicide is a leading cause of death among 10-to-24-year-olds. Primary Care (PC) often serves as a trusted resource for adolescents and young adults (AYA) and their families; and routine wellness visits provide important opportunities for early detection of suicide risk. Importantly, nearly half of those who die by suicide contact their PC clinic within one month prior to suicide. Unfortunately, suicide prevention resources for PC are limited, with a particular gap in short-term risk management and intervention services for lower risk patients and patients with STB who are waiting to be connected to specialty mental health care. Furthermore, parents/caregivers (hereafter referred to as parents) represent a key protective factor for suicidal AYA. Yet, few interventions have been developed to leverage parent support and increase parental self-efficacy to prevent AYA suicide. The current project partners with a digital mental health app, iKinnect, to adapt it for use in PC. iKinnect is designed to improve parent and AYA communication and parental selfefficacy to prevent risk behaviors, including suicide behaviors. The tool uses a parent and AYA paired interface and was originally designed for implementation with high-risk youth involved in the juvenile justice system. Intervention components include parent and AYA content including safety planning, skills for emotion management, parent coaching on lethal means restriction, expectation and goal setting, earning/providing rewards and praise, and modeling videos for parents. While promising, the program has yet to be tested with AYA presenting with suicide risk in PC.
ADHD is common, heritable and impairing. As recognition of the negative functional impacts associated with ADHD in adulthood has grown and stigma around the diagnosis has diminished, demand for ADHD care across the lifespan has increased.
This project will begin foundational work to inform the development of a family-focused lifespan clinic at UW serving adults and children with ADHD. For such a program to be effective, equitable, and sustainable, we must clarify the true needs of individuals living with ADHD as well as the professionals caring for them. We will convene four groups of key community partners: (1) Adults with ADHD whose children have ADHD, (2) Adolescents with ADHD, (3) Mental health professionals representing the fields of psychiatry, psychology, psychiatry advanced practice nursing, school-based counseling, (4) Primary care providers. Results will guide program development and illuminate future research opportunities.
Transgender and gender diverse (TGD) adolescents
experience 4-18 times higher rates of anxiety, 4-23 times higher rates of
depression, 11-54 times higher rates of suicidal ideation, and 2-5 times higher
rates of suicide attempts compared to their cisgender peers. Importantly, parents/guardians
(i.e., caregivers) can have a significant impact on TGD adolescent mental
health, with recent research suggesting that caregiver support and acceptance are
associated with a 30-40% reduction in these mental health concerns.
Community-based support groups are common practice
with TGD adolescents and families. However, group intervention programs that
work specifically with caregivers are rare, and existing programs have not been
formally evaluated. Therefore, the goal of this project is to evaluate TRANSforming
Families: Embracing Change with Teens, a virtual,
multi-family program that was developed by mental health providers in the
Seattle Children’s Gender Clinic (SCGC), to understand its impact on caregiver support
and acceptance and adolescent mental health. This partnership between SCGC
mental health providers and researchers will represent one of the first formal
evaluations of a group intervention program for caregivers of TGD adolescents, the
results of which can inform future implementation and evaluation of this
program in pediatric gender clinics across the United States.
Project includes the design and development of survey instruments for the provider-level skills and agency-level readiness needs assessment and analyzing the data.
Project includes activities surrounding the provision of evaluation, training, and consultation services to PHSKC. These include developing, conducting and analyzing a needs assessment for mental health providers and agency leads to further refine a tier 2/3 model of care. Training and consultation supports will be provided.
