The study will evaluate a novel program developed by our team to improve the effective outpatient management of youth with acute suicide risk. This program evaluation examines just-in time intervention to assess suicide risk level, address imminent risk, and begin treatment to address ideographic suicidal drivers over time. The clinic has served over 200 youth and families since 2019. Qualitative and quantitative data from youth, caregivers, and clinicians demonstrate high levels of fidelity, feasibility, appropriateness, and acceptability, however, impact on core health outcomes has not been conducted. This funding will allow for analysis of the treatment program to demonstrate the impact of the intervention on suicidal thoughts and behaviors.
Targeted Condition: Suicidal Ideation
Collaborative care for perinatal mental health – the LAMMHA project
Los Angeles Maternal Mental Health Access (LAMMHA) is a five year program (2022 – 2027) funded by The California Health Care Foundation (CHCF) to support health centers in Los Angeles to identify and treat common perinatal mental disorders (CPMD) and reduce the risk of suicide. The LAMMHA initiative is a collaboration between Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health and the Department of Psychiatry and Behavioral Sciences at the University of Washington. Co-created with Los Angeles community stakeholders, the LAMMHA program currently offers Los Angeles County providers and community clinics two different levels of support to improve perinatal mental health care.
For more information and/or to apply for the program, please visit the CCALAC LAMMHA page: https://ccalac.org/los-angeles-maternal-mental-health-access-lammha/.
Using technology to scale Caring Contacts and reduce suicide
On top of climate change, political divisiveness and cultural turbulence, we have faced the most devastating pandemic since global influenza 100 years ago. The resulting social and economic stresses have manifested as widespread anxiety, a worsening opioid epidemic and the highest suicide rates in decades.
Proven behavioral health strategies like Caring Contacts offer hope. Caring Contacts is a program where suicidal individuals receive periodic letters or text messages from a behavioral health practitioner, creating a connection and showing someone cares. Caring Contacts have reduced suicide deaths, attempts and thoughts of suicide and offer an easy re-connection to healthcare, but behavioral health practitioners are in high demand and short supply and often struggle with prioritizing messages and sending timely replies. By analyzing a patient’s text messages, computerized algorithms can identify indicators of risk and other important information to help behavioral health practitioners with the nature and timing of their responses, allowing one behavioral health practitioner to reach hundreds of suicidal patients.
This project brings together behavioral health care, mobile technologies that people now expect and innovative informatics methods to identify critical signs of suicide risk that busy practitioners may miss. Our team consists of experts in behavioral health, usability and design, artificial intelligence/natural language processing, software engineering, health care information systems and emergency medicine. Our goal is simple: to use technology to provide critical support for those in crisis, and to save lives.
Understanding mental health problems and health risk behaviors among LGBT Veterans
LGBT Veterans have faced a long history of stigma, discrimination, and exclusionary policies that were intended to exclude them from military service. Despite recent shifts in policy and increased staff trainings, existing evidence suggests that this group is at high risk for health disparities, particularly with respect to mental health and health risk behaviors. While informative, the research to date has been limited in several respects: cross-sectional designs, collapsing LGBT subgroups, severe lack of data on some subgroups, problems with identifying a comparison group, and lack of data on risk and protective factors and care experiences. This prospective cohort study will fill these gaps, recruiting and conducting surveys online with 1,600 Veterans to identify health disparities, test a conceptual model of prospective risk and protective factors, and assess VA utilization, barriers to care, and treatment preferences. Data from this study will inform future intervention efforts to achieve health equity for LGBT Veterans.
Pilot trial of a computerized treatment for mental health symptoms in primary care
This pilot study will leverage Veteran expertise to inform user-centered design improvements and will pilot the effectiveness of a computerized intervention targeting anxiety sensitivity among this patient population.
User-centered design and evaluation of a virtual human patient to improve safety planning skills
The major goals of this project are to develop an interactive, virtual standardized patient to allow VA providers to practice implementing suicide safety planning with training feedback. The project includes a formative evaluation, usability testing, and a randomized pilot trial focused on evaluation of skill acquisition and transfer.
Conceptual design of a virtual standardized patient for suicide safety planning in the Department of Defense
The major goals of this project are to conduct a needs assessment for suicide safety planning training among Department of Defense (DoD) healthcare providers and design paper documentation to support the future development of a virtual standardized patient specific to the needs of DoD providers.
Innovative training for suicide prevention in addiction treatment settings
Although suicide is one of the leading causes of death for people with substance use disorders (SUDs), no widespread suicide prevention intervention exists for delivery in community addiction treatment settings. The effectiveness and feasibility of delivering Preventing Addiction Related Suicide (PARS), a group-based psychoeducational program that provides evidence-based suicide prevention and safety strategies, was recently demonstrated by the UW Center for Suicide Prevention and Recovery.
To enhance widespread implementation and dissemination of PARS, this project will develop online training and implementation tools. PARS-Web will be created in collaboration with key state agencies and suicide prevention professionals to meet the new training requirements for Washington State Chemical Dependency Professionals. The goal is to integrate PARS as a part of standard care in addiction treatment agencies nationwide.
Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment
Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.
Project WISE (Workplace Integrated Support & Education)
The overarching purpose of the research is to adapt and pilot test a technology-enhanced training for hospital nurses in the delivery of a suicide prevention intervention with patients hospitalized for medical reasons.
