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Smith LH, Warren E, Hendrickson N, Joshua K. An Empty Scoping Review of Emergency Department to School Transition for Youth with Mental Health Concerns. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.23.24301673. [PMID: 38343854 PMCID: PMC10854341 DOI: 10.1101/2024.01.23.24301673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The number of youth Emergency Department (ED) visits due to mental health concerns has been steadily increasing with a large number of youth being referred from school. Despite the increase in ED visits, there has not been an increase in the number of students who are actually admitted to the hospital. Further, youth referred from school are more likely to be discharged from the ED. Given the unique relationship between school and ED referrals and the large number of youth who do not require hospitalization, this study sought to understand how schools are supporting students who return to school after an ED visit. We conducted a scoping review to identify programs and practices to support ED to school transition. Two reviewers screened 907 manuscripts, but none of the manuscripts met the inclusion criteria. We discuss the importance of supporting students returning to school from the ED and draw from the literature on hospital to school transition to make recommendations for educators.
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Affiliation(s)
| | - Emily Warren
- University of Virginia, School of Education & Human Development
| | | | - Kate Joshua
- University of Virginia, Claude Moore Health Sciences Library
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Yu SH, Kodish T, Bear L, O’Neill JC, Asarnow JR, Goldston D, Cheng KK, Wang X, Vargas SM, Lau AS. Leader and Provider Perspectives on Implementing Safe Alternatives for Teens and Youth - Acute (SAFETY-A) in Public School Districts Serving Racial/ethnic Minoritized Youth. SCHOOL MENTAL HEALTH 2023; 15:583-599. [PMID: 37622166 PMCID: PMC10449380 DOI: 10.1007/s12310-023-09572-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
Racial/ethnic minoritized (REM) youth represent a high-risk group for suicide, yet there are striking disparities in their use of mental health services (MHS) even after risk is identified in schools. Prior research suggests that school-based risk assessments and hospitalization encounters can be negatively experienced by REM youth and families, thus deterring likelihood of seeking follow-up care. The Safe Alternatives for Teens and Youth-Acute (SAFETY-A) is a brief, strengths-based, cognitive-behavioral family intervention demonstrated to increase linkage to MHS when implemented in emergency departments. With its focus on strengths and family engagement, SAFETY-A may cultivate a positive therapeutic encounter suited to addressing disparities in MHS by enhancing trust and family collaboration, if appropriately adapted for schools. Thirty-seven school district leaders and frontline school MHS providers from districts serving primarily socioeconomically disadvantaged REM communities participated in key informant interviews and focus groups. First, interviews were conducted to understand usual care processes for responding to students with suicidal thoughts and behaviors, and perspectives on the strengths and disadvantages of current practices. An as-is process analysis was used to describe current practices spanning risk assessment, crisis intervention, and follow-up. Second, focus groups were conducted to solicit perceptions of the fit of SAFETY-A for these school contexts. Thematic analysis of the interviews and focus groups was used to identify multilevel facilitators and barriers to SAFETY-A implementation, and potential tailoring variables for implementation strategies across school districts.
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Affiliation(s)
- Stephanie H. Yu
- Department of Psychology, University of California, Los Angeles, CA
| | - Tamar Kodish
- Department of Psychology, University of California, Los Angeles, CA
| | | | - J. Conor O’Neill
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Joan R. Asarnow
- Department of Psychiatry, Child, and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - David Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Karli K. Cheng
- Department of Neurology, Phoenix Children’s Hospital, Phoenix, AZ
| | - Xinran Wang
- Department of Psychology, University of California, Los Angeles, CA
- Department of Psychology and Human Development, Vanderbilt University, TN
| | - Sylvanna M. Vargas
- Department of Psychology, University of California, Los Angeles, CA
- Department of Psychiatry, Child, and Adolescent Psychiatry, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Anna S. Lau
- Department of Psychology, University of California, Los Angeles, CA
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Walsh EH, Herring MP, McMahon J. A Systematic Review of School-Based Suicide Prevention Interventions for Adolescents, and Intervention and Contextual Factors in Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:365-381. [PMID: 36301381 DOI: 10.1007/s11121-022-01449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/26/2022]
Abstract
Suicide is the fourth leading cause of death among adolescents, globally. Though post-primary, school-based suicide prevention (PSSP) has the potential to be a key strategy for preventing adolescent suicidal thoughts and behaviours (STBs), there are persisting challenges to translating PSSP research to practice. Intervention and contextual factors relevant to PSSP are likely key to both PSSP effectiveness and implementation. As such, this systematic review aimed to summarise the effectiveness of PSSP for adolescent STBs and highlight important intervention and contextual factors with respect to PSSP. PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials were searched to identify randomised and non-randomised studies evaluating the effectiveness of interventions located in post-primary, school-based settings targeting adolescent STBs. PSSP effectiveness and intervention and contextual factors were synthesised narratively. Twenty-eight studies were retained, containing nearly 47,000 participants. Twelve out of twenty-nine trials comparing intervention and independent control comparators reported statistically significant reductions in STBs postintervention, and 5/7 trials comparing preintervention and postintervention scores demonstrated significant reductions in STBs over time. Reporting and analysis of intervention and contextual factors were lacking across studies, but PSSP effectiveness and intervention acceptability varied across type of school. Although school personnel commonly delivered PSSP interventions, their input and perspectives on PSSP interventions were lacking. Notably, adolescents had little involvement in designing, inputting on, delivering and sharing their perspectives on PSSP interventions. Twenty out of twenty-eight studies were rated as moderate/high risk of bias, with non-randomised trials demonstrating greater risks of bias and trial effectiveness, in comparison to cluster randomised trials. Future research should prioritise complete reporting and analysis of intervention and contextual factors with respect to PSSP, involving key stakeholders (including adolescents and school personnel) in PSSP, and investigating key stakeholders' perspectives on PSSP. Given the inverse associations between both study quality and study design with PSSP effectiveness, particular consideration to study quality and design in PSSP research is needed. Future practice should consider PSSP interventions with universal components and PSSP which supports and involves key stakeholders in engaging with PSSP.
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Affiliation(s)
- Eibhlin H Walsh
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland.
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland.
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Matthew P Herring
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Jennifer McMahon
- School, Child & Youth (SCY) Mental Health and Wellbeing Research Lab, Department of Psychology, University of Limerick, Limerick, Ireland
- National Institute of Studies in Education, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Chen BC, Lui JHL, Benson LA, Lin YJR, Ponce NA, Innes-Gomberg D, Lau AS. After the Crisis: Racial/Ethnic Disparities and Predictors of Care Use Following Youth Psychiatric Emergencies. JOURNAL OF CLINICAL CHILD & ADOLESCENT PSYCHOLOGY 2022; 52:360-375. [DOI: 10.1080/15374416.2022.2127103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
| | - Joyce H. L. Lui
- Department of Psychology, University of California
- Department of Psychology, University of Maryland
| | | | | | | | | | - Anna S. Lau
- Department of Psychology, University of California
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Marraccini ME, Pittleman C, Griffard M, Tow AC, Vanderburg JL, Cruz CM. Adolescent, parent, and provider perspectives on school-related influences of mental health in adolescents with suicide-related thoughts and behaviors. J Sch Psychol 2022; 93:98-118. [PMID: 35934453 PMCID: PMC9516717 DOI: 10.1016/j.jsp.2022.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
Previous research supports a link between school-related factors, such as bullying and school connectedness, and suicidal thoughts and behaviors. To deepen understanding of how school experiences may function as both protective and risk factors for youth struggling with suicidal thoughts and behaviors, this qualitative study explored multiple perspectives. Specifically, in-depth interviews were conducted with adolescents previously hospitalized for a suicidal crisis (n = 19), their parents (n = 19), and the professionals they may interact with in schools and hospitals (i.e., school professionals [n = 19] and hospital providers [n = 7]). Data were analyzed using applied thematic analysis revealing three main themes related to perceptions of how school experiences can positively or negatively impact mental health, including (a) school activities, (b) school social experiences, and (c) school interventions. An emergent theme related to the complexity of suicide-related risk identified the ways in which school experiences may intersect with other environmental, biological, and psychological factors. Findings underscore the need for school-based approaches to address the unique academic, social, and emotional needs of students with suicide-related risk that complement the supports and services provided in their home and community.
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Kemp K, Pederson CA, Webb M, Williamson S, Elwy AR, Spirito A. Feasibility and acceptability of a brief suicide intervention for youth involved with the family court. BEHAVIORAL SCIENCES & THE LAW 2021; 39:26-43. [PMID: 33569818 DOI: 10.1002/bsl.2498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/30/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
As efforts to develop models for suicide prevention and intervention in the juvenile justice (JJ) system continue to grow, research to understand the feasibility and acceptability of implementing these models is critical. Examining organizational readiness for implementation, ensuring leadership and staff buy-in for delivering the intervention, and planning for sustainability of staff participation in implementation efforts is essential. The current study involved semi-structured formative evaluation interviews with key JJ stakeholders (n = 10) to determine perspectives on the acceptability (perceived need and fit of the intervention) and feasibility (organizational readiness for change) of a proposed brief safety planning intervention for youth with suicidal ideation delivered by nonclinical staff and integrated into the existing system. Qualitative data revealed stakeholders' perceived need for the intervention in the family court context and their agreement that the aims of the intervention were congruent with the goals of the family court. Some barriers to successful implementation were noted, which, addressed through selection of appropriate implementation strategies, can be overcome in a future test of the safety intervention.
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Affiliation(s)
- Kathleen Kemp
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Casey A Pederson
- Department of Pediatrics Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Margaret Webb
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Shannon Williamson
- Rhode Island Hospital Bradley Hasbro Children's Research Center, Providence, Rhode Island, USA
| | - A Rani Elwy
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Anthony Spirito
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
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