Family Based Intervention for Adolescent Suicide Attempters

描述(申请人提供)：减少青少年自杀和自杀企图是2010年健康人健康促进和疾病预防的两个目标。尽管青少年自杀未遂的发病率和死亡率很高，但我们缺乏经验支持的治疗策略和关于最佳实践的共识。这项建议旨在通过制定、试点和评估专门旨在防止再次发生和可能致命的自杀企图的干预方案来解决这一关键的公共卫生问题。这项工作包括两个阶段。在第一阶段，我们将制定和预先测试干预手册和方案、培训和质量保证方案，以及25名青年的遵守措施。在第二阶段，我们将随机分配60名青少年进行安全干预(n=30)或常规护理(n=30)。安全干预是一种为个人量身定做的干预策略，包括：1)以家庭和社区为基础的干预措施，旨在动员家庭和社区网络，支持青年的安全、适应行为和生活理由，并减少导致自杀的因素；2)认知-行为治疗模块，侧重于减少自杀和防止重复自杀企图；以及3)将青年与所需服务和资源联系起来的个性化护理联系战略。在3个月和6个月的随访评估中，由对干预条件视而不见的评估者监测结果。主要结果是：住院；重复自杀未遂的发生率；以及青少年和父母对心理健康服务的满意度。次要结果是：青年抑郁；绝望；生活原因；与心理健康相关的生活质量；以及父母/照顾者的情绪健康。我们检查治疗反应的潜在调节因素(例如，抑郁、年龄、性别、种族)和中介因素(生活原因、绝望、抑郁症状、家庭冲突、社会支持)。为了预测在通常的实践条件下干预的可行性和有效性以及最终社区采用的关键问题，我们将社区精神卫生项目的合作伙伴包括在治疗开发过程中。该项目旨在进一步开发和进行安全计划的初步评估，该计划是一项旨在预防青少年自杀和自杀企图的干预措施。自杀是青少年死亡的第三大原因，减少青少年自杀和自杀企图是我国促进健康和预防疾病的两项国家目标(2010年《健康人》，疾病预防和健康促进办公室，2000年)。

DESCRIPTION (provided by applicant): Reducing suicide and suicide attempts in adolescents are two of the health promotion and disease prevention objectives of Healthy People 2010. Despite the morbidity and mortality associated with suicide attempts in adolescents, we lack empirically supported treatment strategies and consensus regarding best practices. This proposal aims to address this critical public health problem by developing, piloting, and evaluating an intervention protocol aimed specifically at preventing repeat and potentially lethal suicide attempts. The work involves two phases. During Phase 1, we will develop and pretest the intervention manuals and protocol, training and quality assurance protocols, and adherence measures with 25 youth. In Phase 2, we will randomly assign 60 youth to the SAFETY Intervention (n=30) or Usual Care (n=30). The SAFETY Intervention is an individually tailored intervention strategy that integrates: 1) family and community based interventions aimed at mobilizing family and community networks that support youth safety, adaptive behavior, and reasons for living, and decreasing factors contributing to suicidality; 2) cognitive-behavioral treatment modules that focus on decreasing suicidality and preventing repeat suicide attempts; and 3) an individualized care linkage strategy that links youth to needed services and resources. Outcomes are monitored at 3- and 6-month follow-up assessments, by evaluators who are blinded to intervention condition. Primary outcomes are: hospitalizations; incidence of repeat suicide attempts; and youth and parent satisfaction with mental health services. Secondary outcomes are: youth depression; hopelessness; reasons for living; mental health related quality of life; and parent/caregiver emotional well being. We examine potential moderators (e.g. depression, age, gender, ethnicity) and mediators (reasons for living, hopelessness, depressive symptoms, family conflict, social support) of treatment response. To anticipate key issues that are important for intervention feasibility and effectiveness under usual practice conditions and eventual community adoption, we include partners from community mental health programs in the treatment development process. This project aims to further develop and conduct a preliminary evaluation of the SAFETY Program, an intervention aimed at preventing suicide and suicide attempts in adolescents. Suicide is the third leading cause of death among adolescents and reducing suicide and suicide attempts in adolescents are two of our national health promotion and disease prevention objectives (Healthy People 2010, Office of Disease Prevention and Health Promotion, 2000).