SAFETY-A for Promoting Equity in Suicide Prevention Outcomes in Schools

NCT05834660 | Recruiting DMC

• 1 other identifier: 092530369
• Study Type: interventional
• Target: 347
• Locations: 1 country
• Sites: 1

Brief Summary

This study will adapt Safe Alternatives For Teens and Youth - Acute (SAFETY-A) for implementation in low-resourced school districts to reduce racial/ethnic disparities in mental health service use (MHS) following identification of suicide risk in youth. SAFETY-A will be adapted to fit the organizational context of school districts and to reduce mistrust of MHS, internalized stigma, and concealment of youth emotional distress that arise in school suicide risk assessments with Asian American and Latinx students. Following a prototyping case series, a feasibility trial will assign four districts to the timing of SAFETY-A implementation to generate preliminary data on feasibility and impacts on proposed mechanisms and youth MHS utilization and clinical outcomes across racial/ethnic groups.

Conditions

Suicidal Ideation

Keywords

Implementation Feasibility; Implementation Acceptability

Outcome Measures

Primary Outcomes (1)

• Referral Tracking System (Kim et al., 2018)

  As described in Kim, Kodish, Bear, El-Hendi, Duong \& Lau (2018), we will extract mental health service use outcomes from administrative records maintained by each school district. The variable of interest will be Linkage to Outpatient Care, indexed by a receipt of at least one outpatient session following referral to care.

  Six months following the intervention

Secondary Outcomes (1)

• SAFE Alternatives for Teens and Youths - Acute Pre-to-Post intervention Questionnaire (Zullo et al., 2020).

  Change in youth ratings from beginning of the intervention session to the end of the intervention session.

Study Arms (1)

Safe Alternatives for Teens and Youth-Acute for Schools (SAFETY-A for Schools)

EXPERIMENTAL

SAFETY-A is a brief, family centered, cognitive-behavioral approach to therapeutic risk assessment and safety planning that can be delivered via school-based providers. The intervention is delivered in one session during which the youth at risk for suicidal behavior works with the provider to identify strengths, supports, understand emotional antecedents and warning signs, identify alternative coping behaviors and thoughts, and ways to keep the environment safe. Youth and families receive follow-up contacts after the SAFETY-A session. The primary focus is on the therapeutic mechanisms of hope, reduced intensity of suicidal urges, increased confidence in ability to keep safe. Adaptation of SAFETY-A for Schools will target mechanisms that are presumed to drive disparities in mental health service use among Asian American and Latinx youth: (1) trust in mental health services, (2) internalized stigma, and (3) comfort communicating distress.

Behavioral: Safe Alternatives for Teens and Youth-Acute for Schools (SAFETY-A for Schools)

Interventions

Safe Alternatives for Teens and Youth-Acute for Schools (SAFETY-A for Schools) BEHAVIORAL

SAFETY-A is a brief, family centered, cognitive-behavioral approach to therapeutic risk assessment and safety planning that can be delivered via school-based providers. The intervention is delivered in one session during which the youth at risk for suicidal behavior works with the provider to identify strengths, supports, understand emotional antecedents and warning signs, identify alternative coping behaviors and thoughts, and ways to keep the environment safe. Youth and families receive follow-up contacts by phone at 1, 2, and 4 weeks after the SAFETY-A session. The primary focus is on the therapeutic mechanisms of hope, reduced intensity of suicidal urges, increased confidence in ability to keep safe. Adaptation of SAFETY-A for Schools will target mechanisms that are presumed to drive disparities in mental health service use among Asian American and Latinx youth: (1) trust in mental health services, (2) internalized stigma, and (3) comfort communicating distress.

Safe Alternatives for Teens and Youth-Acute for Schools (SAFETY-A for Schools)

Eligibility Criteria

• Age: 11 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 11-19
• Enrolled in participating school district
• Present with suicide thoughts or behavior to school personnel
• Have an identified caregiver who can participate in the intervention

You may not qualify if:

• School personnel determine the student to be at such imminent risk of danger to self that they are unable to benefit from the intervention and must be immediate transported for emergency care.
• Student is unable to participate in the intervention due to indications of intellectual disability, psychosis, or intoxication

Sponsors & Collaborators

• University of California, Los Angeles: lead
• Duke University: collaborator

Study Sites (1)

University of California Los Angeles

Los Angeles, California, 90095, United States

RECRUITING

MeSH Terms

Conditions

Suicidal Ideation

Interventions

Schools

Condition Hierarchy (Ancestors)

Suicide; Self-Injurious Behavior; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Non-Medical Public and Private Facilities

Study Officials

• Anna S Lau, PhD

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anna S Lau, PhD

CONTACT

310-206-5363; alau@psych.ucla.edu

Ashley Flores

CONTACT

aflores@psych.ucla.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: April 13, 2023
• First Posted: April 28, 2023
• Study Start: November 1, 2022
• Primary Completion: August 1, 2025
• Study Completion: August 1, 2025
• Last Updated: February 28, 2025

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)