This study will adapt and evaluate an evidence-based suicide risk screening and follow-up program in two school-based health centers in West Virginia. The suicide screening program is titled the "NIMH Clinical Pathway" and provides tools and procedures for routinely screening adolescents for suicide risk, completing risk assessments, safety planning, lethal means restriction, follow-up referrals, and other disposition planning as appropriate. Investigators aim to do the following: 1. Gather formative data from providers, parents, and youth to inform ways to adapt and implement the NIMH Clinical Pathway so that it can be effectively implemented in rural, Appalachian School-Based Health Centers (SBHCs). 2. Gather preliminary data regarding the feasibility, acceptability, and effectiveness of the adapted intervention.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
30
Complete the implemented workflow and tools for suicide risk screening, assessment, safety planning and follow-up.
West Virginia University
Morgantown, West Virginia, United States
RECRUITINGNumber of Patients Screened for Suicidal Risks-Site 1
Review of patient records for the number of patients that were asked about suicidal thoughts and/or behaviors during their visit. Review will occur for a total of 3 months during the Treatment as Usual Period.
Time frame: Total period of 3 Months
Number of Patients Screened for Suicidal Risks-Site 2
Review of patient records for the number of patients that were asked about suicidal thoughts and/or behaviors during their visit. Review will occur for a total of 6 months during the Treatment as Usual Period.
Time frame: Total period of 6 Months
Number of Patients Reporting Suicidal Risks-Site 1
Review of patient records for the number of patients that reported having suicidal thoughts and/or behaviors. Review will occur for a total of 3 months during the Intervention Period.
Time frame: Total period of 6 Months
Number of Patients Reporting Suicidal Risks-Site 2
Review of patient records for the number of patients that reported having suicidal thoughts and/or behaviors. Review will occur for a total of 6 months during the Interventional Period
Time frame: Total period of 3 Months
Safety Planning Rates (Number)- Site 1
Number of at-risk patients that the providers documented safety planning was completed.
Time frame: Initial Visit
Safety Planning Rates (Number)- Site 1
Number of at-risk patients that the providers documented safety planning was completed.
Time frame: 3 Month Follow Up Visit
Safety Planning Rates (Number)- Site 2
Number of at-risk patients that the providers documented safety planning was completed.
Time frame: Initial Visit
Safety Planning Rates (Number)- Site 2
Number of at-risk patients that the providers documented safety planning was completed.
Time frame: 3 Month Follow Up Visit
Safety Planning Rates (Percentage)- Site 1
Percentage of at-risk patients that the providers documented safety planning was completed.
Time frame: Initial Visit
Safety Planning Rates (Percentage)- Site 1
Percentage of at-risk patients that the providers documented safety planning was completed.
Time frame: 3 Month Follow Up Visit
Safety Planning Rates (Percentage)- Site 2
Percentage of at-risk patients that the providers documented safety planning was completed.
Time frame: Initial Visit
Safety Planning Rates (Percentage)- Site 2
Percentage of at-risk patients that the providers documented safety planning was completed.
Time frame: 3 Month Follow Up Visit
Follow-up Service Provision (Number)- Site 1
Number of at-risk patients that documentation confirms providers conducted follow-up appointments to re-assess suicidal symptoms.
Time frame: Chart review conducted within 3 months following initial visit
Follow-up Service Provision (Number)- Site 2
Number of at-risk patients that documentation confirms providers conducted follow-up appointments to re-assess suicidal symptoms.
Time frame: Chart review conducted within 3 months following initial visit
Participant rate of Suicidal Ideation: (SIQ-Jr)- Site 1
Suicidal Ideation Questionnaire (SIQ-Jr) will be administered to participants at the initial visit and 3 months follow up. The SIQ-Jr is a 15-item self-report questionnaire that measures suicidal thoughts on a 7-point scale ("0- I never had this thought" to "6- I have this thought every day"). Scores range from 0-90, SIQ-Jr scores of 23 and above indicate severe suicidal ideation and the need for clinical intervention.
Time frame: Initial Visit
Participant rate of Suicidal Ideation: (SIQ-Jr)- Site 1
Suicidal Ideation Questionnaire (SIQ-Jr) will be administered to participants at the initial visit and 3 months follow up. The SIQ-Jr is a 15-item self-report questionnaire that measures suicidal thoughts on a 7-point scale ("0- I never had this thought" to "6- I have this thought every day"). Scores range from 0-90, SIQ-Jr scores of 23 and above indicate severe suicidal ideation and the need for clinical intervention.
Time frame: 3 Month Follow Up Visit
Participant rate of Suicidal Ideation: (SIQ-Jr)- Site 2
Suicidal Ideation Questionnaire (SIQ-Jr) will be administered to participants at the initial visit and 3 months follow up. The SIQ-Jr is a 15-item self-report questionnaire that measures suicidal thoughts on a 7-point scale ("0- I never had this thought" to "6- I have this thought every day"). Scores range from 0-90, SIQ-Jr scores of 23 and above indicate severe suicidal ideation and the need for clinical intervention.
Time frame: Initial visit
Participant rate of Suicidal Ideation: (SIQ-Jr)- Site 2
Suicidal Ideation Questionnaire (SIQ-Jr) will be administered to participants at the initial visit and 3 months follow up. The SIQ-Jr is a 15-item self-report questionnaire that measures suicidal thoughts on a 7-point scale ("0- I never had this thought" to "6- I have this thought every day"). Scores range from 0-90, SIQ-Jr scores of 23 and above indicate severe suicidal ideation and the need for clinical intervention.
Time frame: 3 Month Follow Up Visit
Participant rate of Depression: (CES-D)- Site 1
The Center for Epidemiological Studies Depression Scale (CES-D) will be administered to the participant at the initial visit and the 3 month follow up. The CES-D is a self-report measure with 10 items asking about the frequency with which individuals have experienced various symptoms of depression within the last week. Each item is rated on a Likert scale, typically ranging from 0 (rarely or none of the time) to 3 (most or all of the time). Total scores range is from 0-30, with higher scores indicating higher levels of depression.
Time frame: Initial Visit
Participant rate of Depression: (CES-D)- Site 1
The Center for Epidemiological Studies Depression Scale (CES-D) will be administered to the participant at the initial visit and the 3 month follow up. The CES-D is a self-report measure with 10 items asking about the frequency with which individuals have experienced various symptoms of depression within the last week. Each item is rated on a Likert scale, typically ranging from 0 (rarely or none of the time) to 3 (most or all of the time). Total scores range is from 0-30, with higher scores indicating higher levels of depression.
Time frame: 3 Month Follow Up Visit
Participant rate of Depression: (CES-D)- Site 2
The Center for Epidemiological Studies Depression Scale (CES-D) will be administered to the participant at the initial visit and the 3 month follow up. The CES-D is a self-report measure with 10 items asking about the frequency with which individuals have experienced various symptoms of depression within the last week. Each item is rated on a Likert scale, typically ranging from 0 (rarely or none of the time) to 3 (most or all of the time). Total scores range is from 0-30, with higher scores indicating higher levels of depression.
Time frame: Initial Visit
Participant rate of Depression: (CES-D)- Site 2
The Center for Epidemiological Studies Depression Scale (CES-D) will be administered to the participant at the initial visit and the 3 month follow up. The CES-D is a self-report measure with 10 items asking about the frequency with which individuals have experienced various symptoms of depression within the last week. Each item is rated on a Likert scale, typically ranging from 0 (rarely or none of the time) to 3 (most or all of the time). Total scores range is from 0-30, with higher scores indicating higher levels of depression.
Time frame: 3 Month Follow Up Visit
Participants with Suicidal Behavior at Follow Up (Number)- Site 1
Number of participants who indicate "yes" as per the following: Providers will administer the brief version of the Columbia Suicide-Severity Rating Scale (C-SSRS). The C-SSRS is a screening tool that asks two initial questions about suicidal ideation. For participants who state "yes" to either of these questions, they are asked additional questions about suicidal intent, plans, and behavior. Investigators will measure suicidal behavior as a dichotomous "yes"/"no" variable. A participant will be considered a "yes" for this measure if they answer "yes" to the final question about engaging in suicidal preparation and/or attempts on the C-SSRS and to the question asking whether or not they have done so in the past 3 months.
Time frame: 3 Month Follow Up Visit
Participants with Suicidal Behavior at Follow Up (Number)- Site 2
Number of participants who indicate "yes" as per the following: Providers will administer the brief version of the Columbia Suicide-Severity Rating Scale (C-SSRS). The C-SSRS is a screening tool that asks two initial questions about suicidal ideation. For participants who state "yes" to either of these questions, they are asked additional questions about suicidal intent, plans, and behavior. Investigators will measure suicidal behavior as a dichotomous "yes"/"no" variable. A participant will be considered a "yes" for this measure if they answer "yes" to the final question about engaging in suicidal preparation and/or attempts on the C-SSRS and to the question asking whether or not they have done so in the past 3 months.
Time frame: 3 Month Follow Up Visit
Participants with Suicidal Behavior at Follow Up (Percentage)- Site 1
Percentage of participants who indicate "yes" as per the following: Providers will administer the brief version of the Columbia Suicide-Severity Rating Scale (C-SSRS). The C-SSRS is a screening tool that asks two initial questions about suicidal ideation. For participants who state "yes" to either of these questions, they are asked additional questions about suicidal intent, plans, and behavior. Investigators will measure suicidal behavior as a dichotomous "yes"/"no" variable. A participant will be considered a "yes" for this measure if they answer "yes" to the final question about engaging in suicidal preparation and/or attempts on the C-SSRS and to the question asking whether or not they have done so in the past 3 months.
Time frame: 3 Month Follow Up Visit
Participants with Suicidal Behavior at Follow Up (Percentage)- Site 2
Percentage of participants who indicate "yes" as per the following: Providers will administer the brief version of the Columbia Suicide-Severity Rating Scale (C-SSRS). The C-SSRS is a screening tool that asks two initial questions about suicidal ideation. For participants who state "yes" to either of these questions, they are asked additional questions about suicidal intent, plans, and behavior. Investigators will measure suicidal behavior as a dichotomous "yes"/"no" variable. A participant will be considered a "yes" for this measure if they answer "yes" to the final question about engaging in suicidal preparation and/or attempts on the C-SSRS and to the question asking whether or not they have done so in the past 3 months.
Time frame: 3 Month Follow Up Visit
Participants Reporting Safety Plan Usage (Number) - Site 1
Number of participants who screen positive for suicide risk during the initial visit reporting use of the safety plan developed for the participant.
Time frame: 3 Month Follow Up Visit
Participants Reporting Safety Plan Usage (Number)- Site 2
Number of participants who screen positive for suicide risk during the initial visit reporting use of the safety plan developed for the participant.
Time frame: 3 Month Follow Up Visit
Participants Reporting Safety Plan Usage (Percentage)- Site 1
Percentage of participants who screen positive for suicide risk during the initial visit reporting use of the safety plan developed for the participant.
Time frame: 3 Month Follow Up Visit
Participants Reporting Safety Plan Usage (Percentage)- Site 2
Percentage of participants who screen positive for suicide risk during the initial visit reporting use of the safety plan developed for the participant.
Time frame: 3 Month Follow Up Visit
Parents Reporting Safety Plan Usage (Number)- Site 1
Number of parents whose child screened positive for suicide risk during the initial visit reporting the use of the safety plan that was developed for the participant (child).
Time frame: 3 Month Follow Up Visit
Parents Reporting Safety Plan Usage (Number)- Site 2
Number of parents whose child screened positive for suicide risk during the initial visit reporting the use of the safety plan that was developed for the participant (child).
Time frame: 3 Month Follow Up Visit
Parents Reporting Safety Plan Usage (Percentage)- Site 1
Percentage of parents whose child screened positive for suicide risk during the initial visit reporting the use of the safety plan that was developed for the participant (child).
Time frame: 3 Month Follow Up Visit
Parents Reporting Safety Plan Usage (Percentage)- Site 2
Percentage of parents whose child screened positive for suicide risk during the initial visit reporting the use of the safety plan that was developed for the participant (child).
Time frame: 3 Month Follow Up Visit
Participants Reporting Frequency of Safety Plan Use (Number)- Site 1
Number of participants who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Participants Reporting Frequency of Safety Plan Use (Number)- Site 2
Number of participants who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Participants Reporting Frequency of Safety Plan Use (Percentage)- Site 1
Percentage of participants who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Participants Reporting Frequency of Safety Plan Use (Percentage)- Site 2
Percentage of participants who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Parents Reporting Frequency of Safety Plan Use (Number)- Site 1
Number of parents who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Parents Reporting Frequency of Safety Plan Use (Number)- Site 2
Number of parents who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Parents Reporting Frequency of Safety Plan Use (Percentage)- Site 1
Percentage of parents who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Parents Reporting Frequency of Safety Plan Use (Percentage)- Site 2
Percentage of parents who endorse each category related to Safety Plan Usage. Measured on a Likert Type scale with a range of 1-5 ("1-all the time," "2-often," "3-sometimes," "4-almost never," or "5-never") with 1 being more frequent usage and 5 being less frequent usage.
Time frame: 3 Month Follow Up Visit
Participants Reporting Helpfulness of Safety Plan (Number)- Site 1
Number of participants who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Participants Reporting Helpfulness of Safety Plan (Number)- Site 2
Number of participants who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Participants Reporting Helpfulness of Safety Plan (Percentage)- Site 1
Percentage of participants who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Participants Reporting Helpfulness of Safety Plan (Percentage)- Site 2
Percentage of participants who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Parents Reporting Helpfulness of Safety Plan (Number)- Site 1
Number of parents who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Parents Reporting Helpfulness of Safety Plan (Number)- Site 2
Number of parents who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Parents Reporting Helpfulness of Safety Plan (Percentage)- Site 1
Percentage of parents who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Parents Reporting Helpfulness of Safety Plan (Percentage)- Site 2
Percentage of parents who endorse each category related to Safety Plan Helpfulness. Measured on a Likert Type scale with a range of 1-4 ("1-very helpful," "2-helpful," "3-a little helpful," or "4-not at all helpful.") with 1 being most helpful and 4 being least helpful.
Time frame: 3 Month Follow Up Visit
Participants Reporting Acute Care Usage (Number)- Site 1
Number of participants who report acute care was utilized for help with suicidal symptoms between the initial visit and the 3 month follow up visit per participant report.
Time frame: Total period of 3 Months
Participants Reporting Acute Care Usage (Number)- Site 2
Number of participants who reported acute care was utilized for help with suicidal symptoms between the initial visit and the 3 month follow up visit per participant report.
Time frame: Total period of 3 Months
Participants Reporting Acute Care Usage (Percentage)- Site 1
Percentage of participants that reported acute care was utilized for help with suicidal symptoms between the initial visit and the 3 month follow up visit.
Time frame: Total period of 3 Months
Participants Reporting Acute Care Usage (Percentage)- Site 2
Percentage of participants that reported acute care was utilized for help with suicidal symptoms between the initial visit and the 3 month follow up visit.
Time frame: Total period of 3 Months
Parents Reporting Acute Care Usage (Number)- Site 1
Number of parents who report a participant utilized acute care for help with suicidal symptoms between the initial visit and the 3 month follow up visit as per reported by the parent.
Time frame: Total period of 3 Months
Parents Reporting Acute Care Usage (Number)- Site 2
Number of parents who report a participant utilized acute care for help with suicidal symptoms between the initial visit and the 3 month follow up visit as per reported by the parent.
Time frame: Total period of 3 Months
Parents Reporting Acute Care Usage (Percentage)- Site 1
Percentage of parents that reported acute care was utilized for help with participant suicidal symptoms between the initial visit and the 3 month follow up visit.
Time frame: Total period of 3 Months
Parents Reporting Acute Care Usage (Percentage)- Site 2
Percentage of parents that reported acute care was utilized for help with participant suicidal symptoms between the initial visit and the 3 month follow up visit.
Time frame: Total period of 3 Months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.