As rates of pediatric mental health emergencies have
skyrocketed over the last decade – and even more so since the Covid-19 pandemic
– the number of youth staying in emergency departments (EDs) and medical units
while awaiting inpatient psychiatric care or stabilization (i.e., “boarding”)
has reached unprecedented levels. The massive surges in patient volume, coupled
with widespread staff shortages and lack of staff expertise in treating mental
health, are overwhelming ED and hospital resources. This causes dangerous or
even life-threatening delays in care for youth populations in greatest need of
medical and psychiatric treatment. Prolonged ED stays not only delay necessary
mental health care, but they can cause additional trauma and distress for youth
already in crisis. While the boarding crisis affects all hospitals and EDs, it
poses an even greater challenge to community EDs that lack on-site mental
health specialists and/or pediatric providers.
To address the boarding crisis, this project will pilot a
model in which a multidisciplinary team of mental health clinicians at Seattle
Children’s Hospital provides telebehavioral health consultation to community
EDs in Western Washington to guide care for youth who are boarding. The primary
goals of this model are (1) to improve timeliness of mental health care and
reduce length of stay for youth boarding in community EDs, and (2) to support
ED staff in providing more developmentally appropriate and evidence-informed
mental healthcare. The Seattle Children’s team will provide case consultation
to ED providers and staff, including support with decisions about
hospitalization, medication treatment, behavioral interventions and case
management services. The team will also deliver practical trainings to
community ED staff to build their internal capacity to care for boarding youth.
If this initiative is successful, additional funding could expand ED
telebehavioral health consultation services statewide, with a focus on rural
communities.
In the US, approximately one in five adolescent and young adults have seriously thought about suicide and one in 11 have made a suicide attempt. Unfortunately, a third to half of adolescent and young adults who are experiencing suicidal and self-injurious thoughts do not seek professional help and when they do, there is a nationwide shortage of mental health professionals available to support them. When adolescent and young adults are in distress, many seek out support and validation through social media. Some content can be helpful and allow them to find a community where they feel connected, receive the support they need, or share effective coping strategies. Other content can be harmful by encouraging them to commiserate and share or promote harmful coping strategies.
TikTok is the most popular digital platform currently used by over 63% of US adolescent and young adults. Its content recommendation algorithms select and display highly personalized content to each individual user such that the more a user engages with a specific type of content, the more this content will be displayed to them. Many other social media platforms are developing similar content recommendation algorithms to increase user engagement. For adolescent and young adults who are experiencing suicidal thoughts and urges, these content recommendation algorithms can amplify their exposure to suicide-related content and increase suicide risk. The purpose of our project is to identify TikTok content and usage behaviors that increase suicide risk. These findings can inform the development of social media interventions for adolescent and young adults who are experiencing suicidal thoughts and urges.
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.
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.
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.
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.
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.
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.
