Electronic Bridge to Mental Health (eBridge) for College Students

描述（由申请人提供）：自杀行为是大学校园的一个重要问题，自杀是大学生群体死亡的第二大原因。根据国家自杀预防战略中的建议，并由美国自杀预防基金会等组织带头，许多大学已经启动了自愿的网络筛查，以确定学生的自杀风险较高。 自杀和需要心理健康服务。这是一个有希望的方向;然而，需要进行研究，以确定这种方法的效力，以及如何最有效地将筛查结果呈阳性的学生与专业服务联系起来。随着NIMH资助的R34干预发展补助金，我们开发，试点测试和迭代完善了理论驱动的干预措施，学生的eBridge心理健康（eBridge），它确定了自杀风险升高的学生，并促进他们与心理健康（MH）服务的联系。eBridge结合了动机访谈（MI）原则，并借鉴了强调自主和自决的健康行为促进模型。在基于网络的屏幕使用标准化的工具，以确定学生的高风险（积极屏幕上的任何两个或两个以上的：终身自杀企图，目前的自杀意念，酗酒，抑郁症），eBridge为学生提供的选择，接受个性化的反馈（提供在线会话MI-坚持格式）和相应的在线与专业人员在MI培训和了解当地资源。在我们的R34试点随机试验中，控制条件下的学生只收到个性化的反馈，这是自动提供的，并以图形格式。在2个月的随访中，被分配到eBridge的学生报告说：（a）寻求MH服务的准备程度显著提高;（B）与 MH服务;以及（c）链接到MH服务的可能性更高。在这项申请中，我们建议在多所大学进行一项大规模的、有充分把握的随机对照干预试验，以解决以下具体目标：（1）确定eBridge对MH服务、MH结果（自杀想法和行为，抑郁症，酒精/药物滥用）和学业成绩（平均成绩，保留）在6个月的后续行动;（2）检查可能的调解人（性别，基线水平的功能，基线识别的问题）和调解人（参与在线咨询，链接到MH服务）的eBridge的有效性。次要目标包括确定与干预有关的成本和成本效益。如果这种干预措施在他的大规模试验中被证明是有效的，它可以被广泛传播，以解决全国成年大学生的自杀风险和相关的心理健康状况及其不良后果。

DESCRIPTION (provided by applicant): Suicidal behavior is a significant concern on college campuses, and suicide is the second leading cause of death in college student populations. Consistent with recommendations in the National Strategy for Suicide Prevention and spearheaded by organizations such as the American Foundation for Suicide Prevention, many 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 the efficacy of such an approach and how to most effectively link students with positive screens to professional services. With NIMH funding for an R34 intervention development grant, we developed, pilot tested and iteratively refined a theoretically-driven intervention, Students' eBridge to Mental Health (eBridge), which identifies students at elevated suicide risk and facilitates their linkage to mental health (MH) services. eBridge incorporates motivational interviewing (MI) principles and draws from health behavior promotion models that emphasize autonomy and self-determination. Following a web-based screen using standardized instruments to identify students at elevated risk (positive screens on any two or more of: lifetime suicide attempt, current suicidal ideation, alcohol abuse, depression), eBridge offers students the options of receiving personalized feedback (provided online in a conversational MI-adherent format) and corresponding online with professionals trained in MI and knowledgeable about local resources. In our R34 pilot randomized trial, students in the control condition received personalized feedback only, which was provided automatically and in graphic format. At 2-month follow-up, students assigned to eBridge reported (a) significantly higher levels of readiness to seek MH services; (b) significantly lower levels of stigma related to MH services; and (c) a higher likelihood of linking to MH services. In this application, we propose to conduct a large-scale, well-powered randomized controlled intervention trial across multiple universities to address the following specific aims: (1) determine the impact of eBridge on linkage to MH services, MH outcomes (suicidal thoughts and behaviors, depression, alcohol/substance misuse), and academic outcomes (grade point average, retention) at 6-month follow-up; and (2) examine possible moderators (gender, baseline levels of functioning, baseline recognition of problem) and mediators (engagement in online counseling, linkage to MH services) of eBridge effectiveness. Secondary aims include determining the costs associated with, and cost effectiveness of, the intervention. If the intervention is shown to be effective in his large-scale trial, it could be disseminated broadly to address suicide risk and associated mental health conditions and adverse consequences among college adults nationwide.