Using teen Mental Health First Aid to address mental health inequity among school youth

Over 2.5 million US adolescents struggle with mental health challenges, and multiracial adolescents are at greatest risk due to limited access to mental health programs. As roughly half of lifetime mental disorders have their first onset by mid-adolescence, it is vital to promote help-seeking for prevention and early intervention during this important developmental stage.

This project will test the implementation of an evidence-based mental illness prevention program — teen Mental Health First Aid (tMHFA) — in a diverse and underserved school district to facilitate help seeking among teens aged 16-18. While tMHFA has a proven track record of effectively enhancing knowledge of mental health problems, reducing stigma and promoting help-seeking behaviors, its efficacy across dimensions of race and ethnicity is underexamined in the US.

Academic (UW & SMART Center), education (Tacoma Public Schools) and behavioral health organization (MultiCare) stakeholders will address this gap by conducting a mixed-methods study with 1) focus groups to obtain diverse teens aged 15-18 opinions about facilitators and barriers in help-seeking; and 2) longitudinal data collection to examine the impact of the innovative tMHFA’s potential to address help-seeking barriers across dimensions of race and ethnicity. The findings of this project will guide both the revisions to the program to improve its efficacy and the scaling of this program to support government legislation to expand service delivery to other schools and to rural areas across the state.

Addressing suicide risk in primary care to reduce youth suicide

Suicide is a leading cause of death among 10- to 24-year-olds in the US, and half of youth who die by suicide contact a primary care provider within one month prior to suicide. Suicide risk screening and access to brief and effective suicide prevention interventions remain an important step in reducing suicide, yet comprehensive suicide prevention pathways focused on youth have not been widely implemented or evaluated in primary care settings, in part due to lack of trained clinicians and time to provide services.

This project aims to address these challenges by developing clinician training and adapting and optimizing a brief, evidence-based suicide intervention, SAFETY- Acute(A), for use in primary care to support the development of an effective and sustainable primary care-based suicide prevention pathway for youth with low to moderate suicide risk.

WA state parent network to prevent youth suicide and improve student mental health

Rates of suicide and mental health challenges among youth have never been higher. An essential part of youth well-being, mental health and suicide prevention is that parents and other caregivers of youth are prepared to support their children in these challenging times. Asking IS Caring is a parent-caregiver network started in Eastern Washington to provide community education, peer to peer support to families struggling with youth suicide behavior/ death, and input to districts implementing mental health programming and supports. This grant will help put into place essential infrastructure to further develop and to sustain the parent-caregiver network as well as to evaluate programming stemming from the network’s activities. Asking Is Caring is supported by a curriculum designed to offer parents-caregivers an invitation to be present with their child. It offers opportunities for participants to problem solve, and questions they can ask of their child, the parent’s friends, and of themselves. Asking IS Caring provides practical steps to build protection from suicide in the home.

Impact of the Preventing Addiction-Related Suicide (PARS) Intervention on patients who receive community-based addiction treatment

Persons with substance use disorders are 5-10 times more likely to die by suicide than the general public. Recognizing this, Rick Ries, MDKatherine (Kate) Comtois, PhD, MPH, and the UW Center for Suicide Prevention and Recovery (CSPAR) staff developed the first and only suicide prevention intervention successfully developed with and tested in community addiction treatment centers. The primary outcomes of the multisite PARS clinical published in JAMA Network Open in April 2022. Led by Dr. Ries, Kevin Hallgren, PhD, Amanda Kerbrat, LICSW, and Yanni Chang, MD, this project will fund a more detailed secondary analyses to better characterize which patients respond best to the PARS intervention, which in turn will help inform intervention improvements.

Understanding the support needs of gender expansive youth

Approximately 35% of youth who identified as transgender report having attempted suicide in the past 12 months. Despite this high risk, few preventive interventions have been developed specifically to address the unique needs of this group who experience high rates of marginalization, victimization and social isolation based on their gender identities. This study will use human centered design principles to adapt the Caring Contacts intervention for suicide prevention for transgender and gender expansive (TGE) youth and user test this intervention with suicidal ideation who are identified via a Zero Suicide-based screening program in the Seattle Children’s Gender Clinic.

Role of criminal defense attorneys in suicide prevention following defendant arrest

This study will explore the role that criminal defense attorneys could play in reducing risk of suicide amongst recently arrested criminal defendants. Suicide is the leading cause of death in jails and the period after recent arrest may be a particularly vulnerable time for suicide. For many persons with recent arrest, their attorney is one of only a small number of persons that they encounter in the days following arrest. This proposal aims to better understand the experience of the criminal defense attorney in working with clients who have suicidal thinking or behavior; training they have received in the past; desired training (such as suicide risk identification, trauma-informed care, resources); and challenges in disclosures in light of their professional responsibility to preserve client confidences. 

Developing a resource toolkit for clinician survivors of suicide loss

This project will develop a resource toolkit for clinician survivors of suicide loss. For clinicians, the death of a patient by suicide is a dreaded event and can be more distressing than death and dying encountered in other clinical situations. In response to patient suicide, some clinician survivors experience emotional and psychological distress that may reach clinical levels and negative and sometimes persisting effects on professional practice. Building on existing reference materials, we will develop a toolkit of resources to guide and support faculty, clinical staff and trainee clinician-survivors affiliated with the department hospitals. These resources would address educational, emotional, administrative and spiritual needs of clinician-survivors.

Suicide risk screening in acute and intensive care at a Level 1 Trauma Center

Patients hospitalized for medical, surgical, or traumatic injury reasons at Harborview Medical Center are universally screened for suicide risk. The present research will advance knowledge about the practices occurring at this large healthcare institution serving the public and social safety net population and set the groundwork necessary for conducting future research designed to improve services not only at Harborview but at similar institutions across the U.S. A team led by Doyanne Darnell, PhD, and Imara West (Research Scientist at Data Quest) will capture population-level electronic health record (EHR) data on suicide screening rates and outcomes among medically hospitalized patients for a 1-year period and gain insight into the context of the data captured through focus groups with acute/intensive care nurses.

Using routine alcohol screening measures to identify 1-year risk of suicidal ideation, intent, and planning within a large primary care system in Washington

This study will use a large population-based primary care sample in Washington state to understand how heavy alcohol use and alcohol use disorder symptoms contribute to suicidal thoughts. This study will allow examination of how different levels of alcohol use can predict short term risk of suicidality and allow us to better identify and support patients at risk of suicide in the primary care setting.

Consumer perspectives of online & in-person suicide prevention strategies

This study will explore which interventions people with lived experience of suicide find acceptable (e.g., different types of in-person and telehealth care, web-based, text message, app, etc.), who should be the agent to deliver the intervention, and what concerns would they have in having social media and search data used for risk identification and then intervention. These findings have the potential to impact how suicide prevention strategies are brought to scale in a way that is seen as acceptable and appropriate to patients at risk for suicide