Abstract
BackgroundSuicidal thoughts are common among young people presenting to face-to-face and online mental health services. The early detection and rapid response to these suicidal thoughts and other suicidal behaviors is a priority for suicide prevention and early intervention efforts internationally. Establishing how best to use new and emerging technologies to facilitate person-centered systematic assessment and early intervention for suicidality is crucial to these efforts.ObjectiveThe aim of this study was to examine the use of a suicidality escalation protocol to respond to suicidality among help-seeking young people.MethodsA total of 232 young people in the age range of 16-25 years were recruited from either a primary mental health care service or online in the community. Each young person used the Synergy Online System and completed an initial clinical assessment online before their face-to-face or online clinical appointment. A suicidality escalation protocol was used to identify and respond to current and previous suicidal thoughts and behaviors.ResultsA total of 153 young people (66%, 153/232) reported some degree of suicidality and were provided with a real-time alert online. Further levels of escalation (email or phone contact and clinical review) were initiated for the 35 young people (15%, 35/232) reporting high suicidality. Higher levels of psychological distress (P<.001) and a current alcohol or substance use problem (P=.02) predicted any level of suicidality compared with no suicidality. Furthermore, predictors of high suicidality compared with low suicidality were higher levels of psychological distress (P=.01), psychosis-like symptoms in the last 12 months (P=.01), a previous mental health problem (P=.01), and a history of suicide planning or attempts (P=.001).ConclusionsThis study demonstrates the use of new and emerging technologies to facilitate the systematic assessment and detection of help-seeking young people presenting with suicidality. This protocol empowered the young person by suggesting pathways to care that were based on their current needs. The protocol also enabled an appropriate and timely response from service providers for young people reporting high suicidality that was associated with additional comorbid issues, including psychosis-like symptoms, and a history of suicide plans and attempts.
Highlights
Suicidal thoughts are common among young people presenting to traditional face-to-face mental health services and engaging with online mental health services [1,2]
Young people presenting to such services are more likely to engage in suicidal behaviors, which are among the strongest predictors of completed suicide [3,4,5,6]
Suicidal thoughts and behaviors are associated with complex comorbid mental health problems [7], alcohol, or other substance use problems [8], as well as social and economic difficulties that contribute to greater disability [9]
Summary
Suicidal thoughts are common among young people presenting to traditional face-to-face mental health services and engaging with online mental health services [1,2]. Suicidal thoughts and behaviors are associated with complex comorbid mental health problems [7], alcohol, or other substance use problems [8], as well as social and economic difficulties that contribute to greater disability [9] Together, this highlights the need for suicide prevention and early intervention strategies that facilitate the early detection and rapid response to suicidality for those help-seeking young people [10,11]. This highlights the need for suicide prevention and early intervention strategies that facilitate the early detection and rapid response to suicidality for those help-seeking young people [10,11] This is a pertinent issue given that almost half of those who have died by suicide had contact with a primary care provider within one month of the suicide [12], and one-quarter of those with depression who die by suicide are likely to have been in active engagement with mental health services at the time of death [13,14,15,16]. The protocol enabled an appropriate and timely response from service providers for young people reporting high suicidality that was associated with additional comorbid issues, including psychosis-like symptoms, and a history of suicide plans and attempts
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