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Suicide and Self-Injury

(PS13-12) Nine Years of Outcomes: A Youth Suicide Prevention Intensive Outpatient Program

Sunday, November 17, 2024
9:00 AM – 10:00 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Suicide is the second leading cause of death in adolescents, aged 15-19, in the United States, with approximately 13.6% of adolescents experiencing clinically significant suicidal ideation and 7.4% making a suicide attempt during the past twelve months. Despite efforts to prevent adolescent suicide, the rate of suicide deaths continues to increase, suggesting the need for more effective interventions. Historically, suicidal youth have been treated in inpatient settings, but additional options for lower levels of care are warranted. In response to the need, we developed the Suicide Prevention and Resilience at Children’s (SPARC) intensive outpatient program (IOP) in 2014. The treatment includes weekly therapy, twice-weekly group therapy, multi-family groups, and parent psychoeducation all informed by CBT and DBT principles and skills. Admission to the program requires that there be worsening suicidal ideation or a suicide attempt within the past month at the time of intake. A standard battery of measures was collected at intake and discharge and follow-up calls are made at one- and six-months. Between January 2014 and March 2023, SPARC admitted 1409 unique patients with 1177 (83.5%) completing the program. Out of the 1177 unique patients who completed the program during this period, 976 (82.9%) had complete data collected at admission and discharge, of which 593 (60.8%, study sample) had complete data at one- and six-month follow up. Study patients ranged from 10 to 18 years of age (M = 14.8 ± 1.5). 78.1% (n = 463) were female at birth, and 63.6% (n = 377) were White Non-Hispanic. Most referrals to the program came from inpatient units (38.6%, n = 229) and emergency departments (26.1%, n = 155). At admission, 77.7% (n = 461) reported NSSI (nonsuicidal self-injury) in their lifetime, and 45.8% (n = 272) reported a recent suicide attempt (within one month of admission). 4.7% (n = 28) of patients made a suicide attempt while enrolled in the program. At program admission, average depression severity as reported on the QIDS-A17-SR (Quick Inventory of Depressive Symptomatology, Adolescent Version, Self-Report) fell within the moderate range (M = 14.5 ± 5.7). Suicide risk was assessed via the CHRT-SR16 (Concise Health Risk Tracking Self-Report). On average, patients endorsed high propensity for suicide (M = 27.9 ± 9.8) and high risk for suicide (M = 5.4 ± 3.5) using a cutoff of 21 and 4, respectively. At discharge from the program, patient’s average depression severity dropped to the mild range (M = 9.9 ± 5.5, d = .85), while average suicide propensity (M = 19.2 ± 10.5, d = .84) and risk (M = 2.5 ± 2.8, d = .85) both dropped below their respective cutoff. Of patients reached, 2.5% (n = 15) endorsed having made a suicide attempt at one-month follow up, and 8.4% (n = 50) endorsed having made a suicide attempt at six-month follow up.