Safe treatment for emergency presentation for suicidal ideation and behavior (SAFE STEPS): Protocol for randomized controlled trial
Abstract
BACKGROUND
Suicide is currently the second leading cause of death among youth ages 13-24 in the United States. Youths presenting to Emergency Departments (EDs) with suicidal ideation and/or behavior have elevated risk for subsequent suicide attempts and deaths, yet optimal approaches to emergency care remain unclear and too many youths receive inadequate follow-up treatment after discharge.
METHODS
Using a community partnered participatory research model, this multi-site single-blinded randomized comparative effectiveness trial investigates two strategies for enhancing emergency care for 1600 adolescents and young adults (ages 13-24) presenting with suicide attempts and/or suicidal ideation: 1) ED care enhanced by increased access to a developmentally tailored approach to safety planning; and 2) a combined approach that supplements enhanced ED care with brief therapeutic contacts with youths and parents/significant others for 12 months after ED-discharge. These contacts by phone/video/text/letter feature support, brief intervention, and case management. Youths will be recruited from four geographically diverse locations, and assessed at baseline and 3, 6, and 12-month follow-ups. Parent assessments will be at: baseline; 12-month follow-ups; and when youth report is unavailable. Outcomes will be assessed in two domains: 1) clinical [suicide attempts primary, self-harm (suicide attempts+nonsuicidal self-harm) secondary]; 2) service use (linkage to outpatient mental health care…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,600 participants or records.
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