College Students with Elevated Suicide Risk: Enhancing Treatment Linkage

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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.