A Growing, Urgent Health Problem

Suicide rates in the United States have increased by more than 35 percent over the past two decades. During that same period, from 1999 to 2018, suicide rates for youth aged 15 to 24 spiked by almost 50 percent. There is growing concern that the COVID-19 pandemic, with its psychological and sociological effects, will lead to even larger increases in suicide rates.

Additionally, while suicide rates have risen across different population groups, they remain higher for boys and males, and for LGBTQ, homeless, rural, and American Indian/Native Alaskan populations, as well as individuals with disabilities. And although rates for Black and Latinx populations have historically been lower than those for white populations, the recent increasing rates among Black and Latina teenagers is also a cause for specific concern.

What Are Brief Interventions?

Our PFA seeks to fund studies comparing the effectiveness of brief interventions to prevent suicide in youth. Brief interventions—often the first line of help patients receive when concern about suicidality develops or increases—are designed to ease the immediate suicide risk and to direct patients to appropriate longer-term mental health treatment.

Brief interventions generally take up to an hour during a single encounter, and they may include follow-up outreach. Although brief interventions are considered usual care for patients with suicidality, their implementation varies and comparative effectiveness among the different approaches has not been examined. Brief interventions are used for youth at risk for suicide, and benefits have been suggested for hospitalized adolescents. But evidence for effectiveness for underserved populations among youth is sparse.

These interventions can be administered by a range of healthcare workers, including physicians, physician assistants, school counselors, nurses, mental health professionals, and others—and they can be administered in a variety of settings. Of note, providers have recently greatly increased the use of telehealth for suicide prevention due to the restrictions associated with the COVID-19 pandemic.

Learn more about PCORI’s new funding opportunity, which aims to prevent suicide in youths aged 15-24, and register for the applicant town hall September 10. https://pcori.me/2YU5ku0

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Culturally Appropriate Tailoring for Underserved Populations

PCORI seeks to explore culturally tailored interventions that could help vulnerable populations. Cultural tailoring is associated with improved outcomes for a range of conditions and could be similarly helpful for suicide prevention. Tailoring may include involvement of people with lived experience, telehealth, cultural factors, and specific settings or other cultural adaptations. Cultural tailoring is based on input from the targeted population, who have demonstrated that this tailoring can help ease barriers to care.

Preliminary studies of culturally adapted suicide prevention interventions have reported positive results. Applicants to this PFA should justify the types of adaptations they propose.

Specific Requirements for This PFA

All applications must address the priority research question: What is the comparative effectiveness of different evidence-based and/or widely used brief interventions to reduce suicidality and improve outcomes for youth ages 15 to 24?

We invite applications proposing head-to-head comparisons of evidence-based or widely used brief interventions, and/or of culturally adaptations of brief interventions for specific populations of youth. Comparisons of culturally adapted and nonadapted interventions, and of different approaches to cultural adaptation, will be considered.

We will fund applications of up to $10 million in direct costs and up to five years in duration, with up to $30 million in total funding available under this PFA. Letters of Intent are due by September 29, 2020, and full applications due in early 2021.