Youths treated at hospital emergency rooms for suicidal behavior remain at very high risk for future suicide attempts. But despite the urgent need to provide them with mental health follow-up care, many don't receive any such care after their discharge. Consequently, a major goal of the U.S. Department of Health and Human Service's National Strategy for Suicide Prevention has been to increase rates of follow-up care after discharge for patients who come to the emergency department (ED) due to suicidal behavior.
Now, a new study by UCLA researchers shows that a specialized mental health intervention for suicidal youth can help. Reporting in the November issue of the journal Psychiatric Services, Joan Asarnow, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues show that a family-based intervention conducted while troubled youths were still being treated in the ED led to dramatic improvements in linking these youths to outpatient treatment following their discharge.
"Youths who are treated for suicidal behavior in emergency departments are at very high risk for future attempts," said Asarnow, the study's first author. "Because a large proportion of youths seen in the ED for suicide don't receive outpatient treatment after discharge, the United States National Strategy for Suicide Prevention identifies the ED as an important suicide prevention site. So, a national objective is to increase the rates of mental health follow-up treatment for suicidal patients coming out of EDs."
But how to encourage this with youths when they are at their most vulnerable? The study involved 181 suicidal youths at two EDs in Los Angeles County, with a mean age of 15. Sixty-nine percent were female, and 67 percent were from racial or ethnic minority groups. For 53 percent of the participants, their emergency department visit was due to a suicide attempt. The remainder were seen because they had thoughts of suicide.
The youths were randomly assigned to either the usual ED treatment or an enhanced mental health intervention that involved a family-based crisis-therapy session designed to increase motivation for outpatient follow-up treatment and improve the youths' safety, supplemented by telephone contacts aimed at supporting families in linking to further outpatient treatment.
The results of the study show that the enhanced mental health intervention was associated with higher rates of follow-up treatment. Of the participants in the enhanced intervention, 92 percent received follow-up treatment after discharge, compared with 76 percent in the standard ED treatment arm - a clinically significant difference.
While the results are positive, the study is only a first step, according to Asarnow, who also directs UCLA's Youth Stress and Mood Program.
"The results underscore the urgent need for improved community outpatient treatment for suicidal youths," she said. "Unfortunately, the follow-up data collected at about two months after discharge did not indicate clinical or functioning differences among youths who received community outpatient treatment and those who did not."
Still, Asarnow said, the data from the new study underscores the critical importance of this work. To address the need for effective follow-up treatment for troubled youths, the UCLA Youth Stress and Mood Program has major research trials in progress aimed at evaluating outpatient treatments for preventing suicide and suicide attempts.###
Other authors included Larry Baraff, Robert Suddath, John Piacentini, Mary Jane Rotheram-Borus and Lingqi Tang, all of UCLA; Michele Berk and Charles Grob of Harbor–UCLA Medical Center, Los Angeles Biomedical Research Institute; Mona Devich-Navarro of Santa Monica College; and Daniel Cohen of Johns Hopkins University.
Asarnow reports receiving honoraria from Hathaways-Sycamores, Casa Pacifica, the California Institute of Mental Health and the Melissa Institute. Piacentini has received royalties from Oxford University Press for treatment manuals and from Guilford Press and the American Psychological Association Press for books on child mental health. In addition, he has received a consultancy fee from Bayer Schering Pharma. The other authors report no competing interests.
The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The department is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, a world-leading interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.
For more news, visit the UCLA Newsroom and follow us on Twitter.
Mark Wheeler | EurekAlert!
Obstructing the ‘inner eye’
07.07.2017 | Friedrich-Schiller-Universität Jena
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.
To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...
The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....
A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...
Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision
Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...
21.07.2017 | Event News
19.07.2017 | Event News
12.07.2017 | Event News
21.07.2017 | Earth Sciences
21.07.2017 | Power and Electrical Engineering
21.07.2017 | Physics and Astronomy