College Students with Elevated Suicide Risk: Enhancing Treatment Linkage

描述（由申请人提供）：自杀行为是大学校园中一个重要的问题，自杀是美国大学适龄人口死亡的第三大原因。根据国家预防自杀战略（2001年）的建议，在美国预防自杀基金会等组织的带头下，一些大学发起了基于网络的自愿筛查，以确定自杀风险较高和需要心理健康服务的学生。这是一个有希望的方向；然而，需要研究来确定如何最有效地将积极筛选的学生与专业服务联系起来。我们建议开发和试点一种理论驱动的干预措施，即学生e桥治疗（e桥），旨在识别已知自杀风险因素水平较高的学生，并促进这些学生与心理健康服务的联系。e-Bridge将纳入动机性访谈原则，并借鉴健康行为促进模式。我们最初的目标是(1)为那些由于抑郁、酒精/药物滥用或自杀念头或行为而有自杀行为风险的学生开发e-Bridge干预。e-Bridge将包括(a)一个基于网络的屏幕，使用标准化的工具来识别自杀风险较高的学生；(b)个性化反馈；(c)有机会与受过动机性访谈培训并了解当地资源的专业人士在线通信。这与强调自治和自决的模式是一致的。其他目标是(2)对少数风险较高的大学生进行试点可行性研究，(3)进行试点随机对照试验，将e-Bridge与对照条件（个性化反馈和心理健康资源列表）进行比较。在筛查两个月后评估的主要定量结果将是与精神卫生服务的联系。将收集定性数据，说明学生发现对每个干预组件最有帮助和最没有帮助的是什么。次要结果包括：a)自杀念头和行为；B)抑郁严重程度与酒精/药物滥用；c)干预的成本。如果这种干预被证明是有希望的，然后在更大规模的研究中被证明是有效的，它就可以在全国范围内防止大学生自杀和其他不良后果。自杀是年轻人死亡的主要原因。此外，最近的全国调查表明，10%的大学生在过去一年中认真考虑过自杀。根据《国家预防自杀战略》（2001年）的建议，该项目将开发和试点测试“学生通往治疗的电子桥梁”。这种干预将识别自杀行为风险较高的学生，并促进他们与适当治疗的联系。

DESCRIPTION (provided by applicant): Suicidal behavior is a significant concern on college campuses and suicide is the third leading cause of death in the U.S. college-aged population. Consistent with recommendations in the National Strategy for Suicide Prevention (2001) and spearheaded by organizations such as the American Foundation for Suicide Prevention, several universities have initiated voluntary web- based screening to identify students at elevated risk for suicide and in need of mental health services. This is a promising direction; however, research is needed to determine how to most effectively link students with positive screens to professional services. We propose to develop and pilot test a theoretically-driven intervention, Students' e-Bridge to Treatment (e-Bridge), which aims to identify students with elevated levels of known suicide risk factors and facilitate these students' linkage to mental health services. e-Bridge will incorporate motivational interviewing principles and draw from health behavior promotion models. Our initial aim is (1) to develop the e-Bridge intervention for students at risk for suicidal behavior due to depression and alcohol/substance misuse, or suicidal thoughts or behavior. e-Bridge will include (a) a web- based screen using standardized instruments to identify students at elevated suicide risk; (b) personalized feedback; and (c) the opportunity to correspond online with a professional who has been trained in motivational interviewing and is knowledgeable about local resources. This is consistent with a model emphasizing autonomy and self-determination. Additional aims are (2) to conduct a pilot feasibility study with a small number of college students at elevated risk, and (3) to conduct a pilot randomized controlled trial comparing e-Bridge to a control condition (personalized feedback and list of mental health resources). The primary quantitative outcome, assessed two months after screening, will be linkage to mental health services. Qualitative data will be collected about what students found to be most and least helpful about each intervention component. Secondary outcomes will include: a) suicidal thoughts and behavior; b) depression severity and alcohol/substance misuse; and c) the costs of the intervention. If the intervention is shown to be promising and then demonstrated to be effective in larger studies, it could prevent suicides and other adverse consequences among college adults nationwide. Suicide is a leading cause of death among young adults. Moreover, recent national surveys indicate that 10% of college students have seriously considered attempting suicide within the past year. In keeping with recommendations in the National Strategy for Suicide Prevention (2001), this project will develop and pilot test Students' e-Bridge to Treatment. This intervention will identify students at elevated risk for suicidal behavior and facilitate their linkage to appropriate treatments.