Self-Injurious Behavior, Suicide
Conditions
Keywords
Self-injurious thoughts and behaviors (SITB), Peer Support Specialist (PSS), Behavioral health, adolescent, LGBTQ, Juvenile Justice, Foster Care, Crisis Response
Brief summary
This clinical trial will implement and evaluate the feasibility, acceptability, and initial impact of Peer Support Specialist (PSS) services for public system-involved sexual and gender minority (lesbian, gay, bisexual, queer and/or transgender) youth (SGMY) at risk of suicide.
Detailed description
A sharp increase in U.S. youth mental health problems coupled with the national shortage in child behavioral health clinicians has identified peer providers as a cost- and impact-effective solution. Peer Support Specialists (PSS), paraprofessionals with lived experience who provide mutual and structured support, have been found to be effective in improving client engagement in mental health services. The study proposes to evaluate the feasibility, acceptability, and initial impact of a multi-level intervention, Youth Empowerment & Safety (YES), comprised of two coordinated components: 1) system-level improved identification and referral (I/R) of self-injurious thoughts and behaviors (SITB) among sexual and gender minority youth (SGMY), and 2) introduction of an SGMY-tailored support PSS to enhance engagement and support with behavioral health treatment and other support services.
Interventions
BEHAVIORALTreatment as Usual
Behavioral health services (treatment as usual)
BEHAVIORALPeer Support Services (PSS)
Behavioral health services (treatment as usual) along with referral to and utilization of Peer Support Specialist services
Sponsors
Case Western Reserve University
FrontLine Service
National Institute of Mental Health (NIMH)
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
Child Inclusion Criteria: * 12-17 years of age * Self-identify as a sexual or gender minority (SGM) * Involved in one or more system: juvenile justice, child welfare, and/or community-based mental health * Personal experience with self-injurious thoughts and behaviors (SITB) * English speaking * Willing and able to provide informed assent Child
Exclusion criteria
* Less than 12 or greater than 17 years of age (0-11 or 18 and over) * Do not self-identify as a sexual or gender minority (SGM) * Not involved in the juvenile justice, child welfare, and/or community-based mental health systems * No personal experience with self-injurious thoughts and behaviors (SITB) * Not English speaking * Unwilling and/or unable to provide informed assent Caregiver Inclusion Criteria: * 18-80 years of age * Primary Caregiver of youth who meet child inclusion criteria listed above * English speaking * Willing and able to provide informed consent Caregiver
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Youth-level changes in Recovery | Baseline, Post-Intervention 3 Month, and Post Intervention 6 Month | The researchers will compare the change in treatment engagement as quantified by total score on two separate subscales of the Questionnaire about the Process of Recovery (the QPR). The QPR is a 22-item measure developed from service users' accounts of recovery in collaboration with local service users. Each item is scored using a 5-point Likert scale ranging from 0 (disagree strongly) to 4 (agree strongly). There are two subscales: 1) intrapersonal tasks involved in recovery (17 items, range 0-68) and 2) interpersonal factors that facilitate recovery (5 items, range 0-20) with higher scores indicating increased recovery on both subscales. |
| Youth Level Changes in Self-injurious thoughts and behaviors | From enrollment (baseline), to 3- and 6 months follow ups post treatment at the end of 8-12 weeks. | The researchers will compare changes in suicidal ideation, planning, attempt and non-suicidal self-harm in a group of pre-intervention (nonrandomized) youth to post-intervention (nonrandomized youth) using the Columbia Suicide Severity Rating Scale (C-SSRS), a widely used and well-validated measure of suicidal ideation, planning, attempt, and non-suicidal self-harm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire - Depression Scale - PHQ-9 | Study enrollment (baseline) and 3- and 6-month follow-ups | The Patient Health Questionnaire - Depression Scale (PHQ-9) is a validated measure of depression consisting of nine questions that assess the severity of depressive symptoms over the past two weeks. Each item is scored using a 4-point Likert scale ranging from 0 (Not at all) to 3 (Nearly every day). The scale provides a cumulative score (range from 0-27) with higher scores suggesting more severe depressive symptoms. |
| Youth level changes in minority stress | baseline, 3- month post, 6-month follow up | The researchers will assess changes in minority stress, as measured by the Adolescent Minority Stress Inventory. This is a 26-item measure of minority stressors experienced by LGBTQ+ youth in the past 30 days utilizing a binary Yes/No scale (yes = 1, no = 0). The scale provides a cumulative score (range from 0-30) with higher scores suggesting higher stress. |
| Youth Level Changes in Perceived Parent Acceptance | baseline, 3-month post, 6 month follow up | The Family Acceptance Measure is a 6-item measure of youths' perception of accepting and rejecting attitudes and behaviors of LGBTQ+ youth. Each item is scored using a 4-point Likert scale ranging from 0 (Never) to 3 (Often). The scale provides a cumulative score (range from 0-18) with higher scores suggesting less familial acceptance. |
Countries
United States
Contacts
CONTACTDana M. Prince, PhD
PRINCIPAL_INVESTIGATORDana M. Prince, PhD
Case Western Reserve University
Outcome results
None listed