Brief Suicide Intervention for Youth in Juvenile Detention Settings

对少年拘留所中青少年的简短自杀干预

基本信息

批准号：
10408683
负责人：
DAVID B. GOLDSTON
金额：
$ 23.79万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-01 至 2024-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10408683
关键词：
Address Adolescent Anxiety Behavior Behavioral Caring Cessation of life Cognitive Complement Conduct Disorder Data Death Rate Development Dialectical behavior therapy Distress Emergency medical service Environment Evaluation Feedback Feeling suicidal Funding Opportunities Future General Population Goals Human Resources Intervention Justice Life Life Experience Mental Depression Mental Health Mental Health Services Mental disorders Modeling Monitor National Institute of Mental Health North Carolina Outcome Patient Recruitments Pilot Projects Procedures Professional counselor Protocols documentation Randomized Randomized Controlled Trials Recording of previous events Reporting Research Research Priority Resources Review Literature Risk Risk Factors Safety Secure Self Efficacy Self-Injurious Behavior Service setting Services Site Substance abuse problem Suicide Suicide attempt Suicide prevention Testing Time Training Training and Education Trauma Validation Work Youth acceptability and feasibility adverse event monitoring base brief intervention design disorder risk effectiveness implementation study effectiveness trial evidence base expectation experience follow-up high risk population ideation improved improved outcome intervention effect juvenile justice system member multi-component intervention non-suicidal self injury prevent preventive intervention randomized trial screening service delivery skills staff intervention substance use suicidal suicidal adolescent suicidal behavior suicidal morbidity suicidal risk suicide rate therapy development

项目摘要

Youth with juvenile justice involvement are at markedly increased risk for suicidal ideation, suicidal behavior and death, and non-suicidal self-injury (NSSI) (Gallagher & Dobrin, 2006; Stokes et al., 2015). Much of this suicidal and self-harm behavior occurs in the context of psychiatric and substance use problems and histories of adverse life experiences (e.g., Charak et al., 2019; McNair et al., 2019; Teplin et al., 2015). The rates of mental health disorders and suicide risk increase with more restrictive environments, including juvenile detention facilities (Hayes, 2005; Stokes et al., 2015; Wasserman, et.al., 2010). Given the increased risk of detained youth, the purpose of this study, responsive to NIMH PAR 18-228, “Pilot Studies to Detect and Prevent Suicidal Behavior, Ideation, and Self-Harm in Youth in Contact with the Juvenile Justice System,” is to develop, refine, and preliminarily test a trauma-informed, strengths-based, developmentally appropriate brief intervention for staff in short-term detention facilities responding to detained adolescents’ suicidal ideation and behavior, and NSSI. It is our expectation that this brief intervention will provide support to detained youth through cognitive-behavioral and dialectical behavior therapy strategies focused on increasing youth safety, self-efficacy, reasons for living, and radical acceptance of their current life circumstances. The intervention will be designed to help staff more effectively assess and respond to youth suicidal thoughts and behaviors, and NSSI, resulting in more effective management of youth crises. The intervention will complement and build upon existing resources and assessment and monitoring protocols within the juvenile detention setting. In particular, the intervention will be designed to be delivered on- site at detention facilities by existing detention staff who work with detained youth. The first aim of the project is to develop and refine standard procedures for the new intervention for suicidal youths in crises in juvenile detention. The second aim is to develop procedures for training detention staff members who will provide this intervention to detained youth. In the context of an open trial (n=20), the third aim is to assess the feasibility of this intervention, and to use experiences from implementing the intervention and feedback from detention staff and youth to refine the intervention. The last aim is to obtain, in a pilot randomized controlled trial (n=200), preliminary data regarding the feasibility and acceptability of the intervention, as well as the impact of the intervention on suicidal thoughts and behavior, NSSI, emergency services, linkage to care after release, and presumed mechanisms of action. The proposed research is intended to demonstrate the feasibility and potential utility of a model that can eventually impact services delivery by detention staff for detained at-risk youth, resulting in improved outcomes. The results of this study will inform the development of a future larger scale hybrid implementation effectiveness trial.

参与少年司法的青少年自杀意念和自杀行为的风险显着增加以及死亡和非自杀性自伤 (NSSI)（Gallagher & Dobrin，2006；Stokes 等人，2015）。自杀和自残行为发生在精神和药物使用问题和病史的背景下不良生活经历的影响（例如，Charak 等人，2019 年；McNair 等人，2019 年；Teplin 等人，2015 年）。随着环境（包括青少年）受到更多限制，精神健康障碍和自杀风险会增加拘留设施（Hayes，2005 年；Stokes 等人，2015 年；Wasserman 等人，2010 年）。被拘留青少年，本研究的目的，响应 NIMH PAR 18-228，“检测和 “通过少年司法系统预防青少年的自杀行为、意念和自残” 制定、完善并初步测试一份基于创伤、基于优势、适合发展的简介针对被拘留青少年的自杀意念对短期拘留设施工作人员进行干预我们期望这一简短的干预将为被拘留的青少年提供支持。通过专注于提高青少年安全的认知行为和辩证行为治疗策略，自我效能感、生活理由以及对当前生活状况的彻底接受。旨在帮助工作人员更有效地评估和应对青少年的自杀想法和行为，以及 NSSI，从而更有效地管理青年危机，该干预措施将是补充和基础。少年拘留场所内的现有资源以及评估和监测协议特别是，干预措施将由现有拘留设施工作人员在拘留设施现场进行，他们该项目的首要目标是制定和完善新的标准程序。对少年拘留危机中的自杀青少年进行干预的第二个目标是制定干预程序。培训拘留工作人员，他们将在公开的背景下向被拘留青少年提供这种干预。试验（n=20），第三个目的是评估这种干预措施的可行性，并利用来自实施干预措施并听取拘留人员和青少年的反馈，以完善干预措施。目的是通过一项试点随机对照试验（n=200）获得有关可行性和可行性的初步数据干预的可接受性，以及干预对自杀想法和行为的影响， NSSI、紧急服务、释放后与护理的联系以及假定的行动机制。研究的目的是证明模型的可行性和潜在效用，最终会影响拘留工作人员为被拘留的高危青少年提供服务，从而改善结果。这项研究将为未来更大规模的混合实施有效性试验的发展提供信息。