The BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth

项目摘要 自杀是美国15至24岁青少年的第二大死因。与他们的 异性恋和顺性别同龄人、性少数和性别少数(SGM)青少年报告的比例显著高于 自杀意念和自杀未遂的比率。不幸的是，许多障碍使执行 SGM社区中的自杀预防。SGM的年轻人经常报告说，在 传统的行为健康服务机构。因此，治疗出勤率和保留率仍然存在。 很低。相反，这些人通常在社区组织中为女同性恋者寻求心理健康服务， 同性恋、双性恋、变性人和同性恋(LGBTQ)青年。不幸的是，这些组织经常 对这一临床挑战毫无准备。行为健康工作(BH-Works)自杀风险管理 系统可能为这一问题提供一种潜在的解决方案。BH-Works是一位循证、全面的青年 自杀预防计划。它为政策制定、员工培训、自杀和行为提供支持 健康检查、技术辅助的安全规划、电子患者转诊系统、实时数据 用于项目监控的分析，以及支持可持续发展的学习协作结构。所有功能 在基于网络的软件平台上得到支持，以促进实施、采用和扩展。BH- Works已在临床和非临床环境中使用。在这个项目中，我们将把这个程序改编成 LGBTQ组织。该项目建立在与两个不同的LGBTQ组织的牢固伙伴关系的基础上 (费城的Mazzoni中心和弗吉尼亚州西南部农村的多样性营地公司)和合作 行为健康网站。我们将使用有效实施混合类型2设计(Curran等人， 2013)与一个历史比较小组在两个LGBTQ组织内试行BH-Works计划。 在实施研究综合框架的指导下，我们将试行一项 实施战略。此战略侧重于促进参与、建立合作伙伴关系和创建 可持续性在第一年，我们将像往常一样收集治疗数据，与我们的合作伙伴合作适应BH-Works 内容、实践和工作流程。我们还将培训工作人员/提供者在自杀风险管理、家庭 参与和平权关怀。在第二年，我们将开始试行SGM BH-Works筛选和 推荐系统。我们将评估主要项目的结果(增加自杀身份识别和成功 转介)、次要结果(计划可接受性)和探索计划机制(培训影响、 伙伴关系发展、软件可用性和照顾者参与)。这项拟议的研究回应了 越来越多的国家需要确定和转介有自杀风险的弱势青年。未来的R01将测试 更大样本和不同实施策略的方案有效性。

PROJECT ABSTRACT Suicide is the second leading cause of death for 15-to-24-year-olds in the United States. Compared to their heterosexual and cisgender peers, sexual and gender minority (SGM) adolescents report significantly higher rates of suicidal ideation and suicide attempts. Unfortunately, many barriers complicate the implementation of suicide prevention in SGM communities. SGM youth often report feeling unwelcome and misunderstood in traditional behavioral health service organizations. Consequently, treatment attendance and retention remain low. Instead, this population generally seeks mental health services in community organizations for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Unfortunately, these organizations are often unprepared for this clinical challenge. The Behavioral Health-Works (BH-Works) suicide risk management system may offer a potential solution to this problem. BH-Works is an evidence-based, comprehensive youth suicide prevention program. It offers support for policy development, staff training, suicide and behavioral health screening, technology-assisted safety planning, an electronic patient referral system, real-time data analytics for program monitoring, and a learning collaborative structure to support sustainability. All functions are supported on a web-based software platform that facilitates implementation, adoption and expansion. BH- Works has been used in both clinical and non-clinical settings. In this project, we will adapt this program for LGBTQ organizations. This project builds upon robust partnerships with two diverse LGBTQ organizations (Mazzoni Center, in Philadelphia and Diversity Camp Inc., in rural Southwest, Virginia) and partnering behavioral health sites. We will use an Effectiveness-Implementation Hybrid Type 2 design (Curran et al., 2013) with a historical comparison group to pilot the BH-Works program within the two LGBTQ organizations. Informed by the Consolidated Framework for Implementation Research, we will pilot test a sequenced implementation strategy. This strategy focuses on promoting engagement, building partnership, , and creating sustainability In Year 1, we will collect treatment as usual data, work with our partners to adapt BH-Works content, practices, and workflow. We will also train staff/providers in suicide risk management, family engagement and affirmative care. In Year 2, we will begin pilot testing the SGM BH-Works screening and referral systems. We will evaluate primary program outcomes (increased suicide identification and successful referrals), secondary outcomes (program acceptability), and explore program mechanisms (training impact, partnership development, software usability and caregiver involvement). The proposed research responds to the growing national need to identify and refer vulnerable youth at risk for suicide. A future R01 will test program effectiveness with a larger sample and different implementation strategies.