Project Summary
PCORI has identified suicide prevention among youth ages 15-24 as an important research topic. Suicide rates in the United States have increased over the past two decades, especially for youth. Patients, caregivers, clinicians, and others want to learn: How do different brief interventions compare for preventing immediate risk of suicide and helping youth access longer-term mental health treatment? To help answer this question, PCORI launched an initiative in 2020 on Suicide Prevention: Brief Interventions for Youth. The initiative funded this research project and others.
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Suicide is the second leading cause of death among youth in the United States. Youth who are sexual and gender diverse, or SGD, are at the highest risk for suicide. SGD includes people who are lesbian, gay, bisexual, transgender, queer, or of a sexual or gender identity that is not heterosexual or cisgender. SGD youth are more likely to have symptoms of depression and thoughts of suicide. They may also lack the support they need from the people in their lives.
In this study, the research team is comparing two ways to help SGD youth who are at risk for suicide.
Who can this research help?
Results may help doctors and mental health clinicians when considering ways to reduce thoughts of suicide in SGD youth who are being treated at primary care clinics.
What is the research team doing?
The research team is adapting and testing two ways to decrease thoughts of suicide. In the first approach, primary care clinicians, such as doctors and nurses, are using an approach based on motivational interviewing, or MI, to help youth learn problem-solving skills and access mental health care. MI is a counseling strategy in which clinicians help motivate patients to make changes in their lives.
In the second approach, a clinician is connecting youth with mental health services. The youth are also choosing a team of adults as support people. Support people meet regularly with the youth to provide support and encouragement to seek mental health services when needed. Support people are receiving training and taking part in sessions to learn how to help.
The research team is first enrolling 40 SGD youth who are at risk for suicide. The youth receive primary care at clinics in the Dallas and Austin, Texas areas. The team is assigning the clinics by chance to offer one of the two approaches. Youth are answering surveys when they enroll and two months later. The research team is adapting the two approaches based on survey responses and feedback.
Then, the research team is testing the adapted approaches. To do so, the team is enrolling 598 SGD youth who are at increased risk for suicide. Youth are receiving care at one of 34 clinics in the Dallas, Austin, and San Antonio, Texas areas. The team is assigning clinics by chance to provide one of the approaches. Youth at the clinics are answering surveys at the start of the study and 1, 3, 6, 9, and 12 months later. Surveys ask about thoughts of suicide, use of mental health services, suicide attempts, feelings of depression, social support, and stigma. The team is also collecting data on the number of deaths by suicide among these youth.
SGD youth and community members are providing input for the study.
Research methods at a glance
| Design Element | Description |
|---|---|
| Design | Pilot study and cluster randomized controlled trial |
| Population |
Pilot: 40 SGD youth ages 18–24 with increased risk for suicide Cluster randomized controlled trial: 598 SGD youth ages 18–24 with increased risk for suicide |
| Interventions/ Comparators |
|
| Outcomes |
Primary: suicidal ideation Secondary: suicide attempts, death by suicide, psychiatric hospitalization, depressive symptoms, social support, internalized stigma |
| Timeframe | 6-month follow-up for primary outcome |