The development of a family navigator intervention and prevention protocol to reduce risk of suicide and self-injurious behavior for youth aged 10 to 14 years.

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Pandemic-period changes have been observed in recent rates for youth aged 10 to 14 on suicidal and non-suicidal self-injurious behavior (hereinafter referred to as SSIB), where they are now presenting with SSIB at rapidly increasing rates. This unique group of youth is of great interest, because SSIB prevention protocols are needed to reduce SSIB risk as well as decrease prevalence rates. Pediatric emergency departments (EDs) have become an essential and often routine mental health service for youth. EDs are optimal sites to initiate youth SSIB prevention protocol, as they are often the first point of entry for youth into the mental health system. Despite high rates of youth seen in the ED for SSIB, effective ED interventions to reduce SSIB risk and increase attendance and adherence to subsequent community-based mental health care are lacking. The purpose of this pilot study is to develop and pilot a Family Navigator (FN) with technology-enhanced information sharing via texting intervention for families with youth who were discharged from the ED after an admission for SSIB. This intervention aims to reduce SSIB risk and prevalence rates, as well as increase engagement in community-based mental health services for youth aged 10 to 14. This intervention is informed by the literature, evidence-based hospital intervention protocols, a family-based approach for youth development stages, and developed to directly target three mechanisms. This study will develop a brief FN modeling enhanced with technology-delivered information shared (automated sharing of information with families via text). Thus, qualitative methods will be employed to assist in the refinement of the intervention, thus maximizing ecological validity. At the outcome of this study, FN acceptability and feasibility as well as manual development will be completed. Balanced randomization will occur to either the treatment as usual (TAU) condition or the Family Navigator (FN) with information sharing condition. Primary outcomes, measured at 4- and 6-month follow-ups, include reduce SSIB risk and prevalence rates, increased attendance and adherence to youth community-based mental health care, and the engagement of the purported therapeutic mechanisms. This pilot study will set the stage for a NIMH R01 application via a Type I Hybrid Effectiveness-Implementation trial to speed translation of research findings to practice.