Brief Suicide Intervention for Youth in Juvenile Detention Settings

对少年拘留所中青少年的简短自杀干预

• 批准号: 10408683
• 负责人: DAVID B. GOLDSTON
• 金额: $ 23.79万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408683
• 关键词: Address; Adolescent; Anxiety; Behavior; Behavioral; Caring; Cessation of life; Cognitive; Complement; Conduct Disorder; Data; Death Rate; Development; Dialectical behavior therapy; Distress; Emergency medical service; Environment; Evaluation; Feedback; Feeling suicidal; Funding Opportunities; Future; General Population; Goals; Human Resources; Intervention; Justice; Life; Life Experience; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Modeling; Monitor; National Institute of Mental Health; North Carolina; Outcome; Patient Recruitments; Pilot Projects; Procedures; Professional counselor; Protocols documentation; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Research Priority; Resources; Review Literature; Risk; Risk Factors; Safety; Secure; Self Efficacy; Self-Injurious Behavior; Service setting; Services; Site; Substance abuse problem; Suicide; Suicide attempt; Suicide prevention; Testing; Time; Training; Training and Education; Trauma; Validation; Work; Youth; acceptability and feasibility; adverse event monitoring; base; brief intervention; design; disorder risk; effectiveness implementation study; effectiveness trial; evidence base; expectation; experience; follow-up; high risk population; ideation; improved; improved outcome; intervention effect; juvenile justice system; member; multi-component intervention; non-suicidal self injury; prevent; preventive intervention; randomized trial; screening; service delivery; skills; staff intervention; substance use; suicidal; suicidal adolescent; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; therapy development

Youth with juvenile justice involvement are at markedly increased risk for suicidal ideation, suicidal behavior and death, and non-suicidal self-injury (NSSI) (Gallagher & Dobrin, 2006; Stokes et al., 2015). Much of this suicidal and self-harm behavior occurs in the context of psychiatric and substance use problems and histories of adverse life experiences (e.g., Charak et al., 2019; McNair et al., 2019; Teplin et al., 2015). The rates of mental health disorders and suicide risk increase with more restrictive environments, including juvenile detention facilities (Hayes, 2005; Stokes et al., 2015; Wasserman, et.al., 2010). Given the increased risk of detained youth, the purpose of this study, responsive to NIMH PAR 18-228, “Pilot Studies to Detect and Prevent Suicidal Behavior, Ideation, and Self-Harm in Youth in Contact with the Juvenile Justice System,” is to develop, refine, and preliminarily test a trauma-informed, strengths-based, developmentally appropriate brief intervention for staff in short-term detention facilities responding to detained adolescents’ suicidal ideation and behavior, and NSSI. It is our expectation that this brief intervention will provide support to detained youth through cognitive-behavioral and dialectical behavior therapy strategies focused on increasing youth safety, self-efficacy, reasons for living, and radical acceptance of their current life circumstances. The intervention will be designed to help staff more effectively assess and respond to youth suicidal thoughts and behaviors, and NSSI, resulting in more effective management of youth crises. The intervention will complement and build upon existing resources and assessment and monitoring protocols within the juvenile detention setting. In particular, the intervention will be designed to be delivered on- site at detention facilities by existing detention staff who work with detained youth. The first aim of the project is to develop and refine standard procedures for the new intervention for suicidal youths in crises in juvenile detention. The second aim is to develop procedures for training detention staff members who will provide this intervention to detained youth. In the context of an open trial (n=20), the third aim is to assess the feasibility of this intervention, and to use experiences from implementing the intervention and feedback from detention staff and youth to refine the intervention. The last aim is to obtain, in a pilot randomized controlled trial (n=200), preliminary data regarding the feasibility and acceptability of the intervention, as well as the impact of the intervention on suicidal thoughts and behavior, NSSI, emergency services, linkage to care after release, and presumed mechanisms of action. The proposed research is intended to demonstrate the feasibility and potential utility of a model that can eventually impact services delivery by detention staff for detained at-risk youth, resulting in improved outcomes. The results of this study will inform the development of a future larger scale hybrid implementation effectiveness trial.

青少年司法参与的青少年自杀意念，自杀行为的风险显着增加 和死亡，以及非自杀性自伤（NSSI）（Gallagher和Dobrin，2006; Stokes等人，2015年）。这在很大程度 自杀和自残行为发生在精神和物质使用问题和历史的背景下 不良的生活经历（例如，Charak等人，2019; McNair等人，2019; Teplin等人，2015年）的报告。率 心理健康障碍和自杀风险随着更多限制性环境的增加而增加，包括青少年 拘留设施（Hayes，2005年; Stokes等人，2015; Wasserman等人，2010年）。鉴于风险增加， 被拘留的青年，这项研究的目的，响应NIMH PAR 18-228，“试点研究，以检测和 预防青少年司法系统中的自杀行为，想法和自我伤害，”是为了 制定、完善并初步测试一份基于创伤的、基于优势的、适合发展的简报 对短期拘留设施的工作人员进行干预，以应对被拘留青少年的自杀意念， 行为，和NSSI。我们期望这一简短的干预将为被拘留的青年提供支持， 通过认知行为和辩证行为治疗策略，重点是增加青少年的安全， 自我效能、生活理由以及对当前生活状况的彻底接受。干预将 旨在帮助工作人员更有效地评估和应对青少年自杀想法和行为，以及 国家青年安全倡议，从而更有效地管理青年危机。干预措施将补充和加强 现有资源以及少年拘留环境中的评估和监测规程。特别是， 干预措施将由现有的拘留所工作人员在拘留所现场提供， 与被拘留的年轻人一起工作。该项目的第一个目标是制定和完善标准程序， 对青少年拘留所危机中有自杀倾向的青少年进行干预。第二个目标是制定程序， 培训拘留所工作人员，由他们向被拘留青年提供这种干预。在开放的背景下， 试验（n=20），第三个目的是评估这种干预的可行性，并利用经验， 实施干预措施，并听取拘留所工作人员和青年的反馈意见，以完善干预措施。最后一 目的是在一项初步随机对照试验（n=200）中获得关于可行性和 干预的可接受性，以及干预对自杀想法和行为的影响， NSSI，紧急服务，与释放后护理的联系，以及假定的行动机制。拟议 研究的目的是证明一个模型的可行性和潜在效用，最终可以影响 拘留所工作人员为被拘留的问题青年提供服务，结果有所改善。的结果 这项研究将为未来更大规模的混合执行有效性试验的开发提供信息。