TY - JOUR
T1 - The Development and Feasibility Outcomes of a Youth Suicide Prevention Intensive Outpatient Program
AU - Kennard, Beth
AU - Mayes, Taryn
AU - King, Jessica Davidson
AU - Moorehead, Alexandra
AU - Wolfe, Kristin
AU - Hughes, Jennifer
AU - Castillo, Brooke
AU - Smith, Mikah
AU - Matney, Jacquelyn
AU - Oscarson, Brandon
AU - Stewart, Sunita M
AU - Nakonezny, Paul A
AU - Foxwell, Aleksandra A
AU - Emslie, Graham
N1 - Funding Information:
The authors are grateful for the patients and their families, who provided invaluable feedback that contributed to the development of the program. We especially would like to acknowledge Dr. David Brent, Kim Poling, Dr. Tina Goldstein, and the Services for Teens at Risk staff who have generously provided mentorship and guidance. We would like to specifically thank the SPARC-IOP providers (Jeff Armstrong, Karla Hutcherson, Remy Nadelman, and Hayley Burgess), the psychology and masters level trainees, and the psychiatry residents for their tremendous contributions to the development of the treatment program. We also appreciate the support of the director of psychiatry, Jeanne Nightingale, RN, MS, and the leadership of Children's Health for their recognition of the clinical need and the vision for a suicide program. We would also like to acknowledge the support and partnership of the Hannah4Hope foundation, an organization that continues to inspire us through their meaningful contributions to our community. Conflict of Interest: Dr. Kennard receives research support from the National Institute of Mental Health and royalties from Guilford Press. Dr. Foxwell receives royalties from Guilford Press. Dr. Emslie has received research support from Duke University and Forest Laboratories, Inc., and has been a consultant for Allergan, Assurex Health, Inc., INC Research Inc, Lundbeck, Neuronetics, Otsuka, Pfizer Inc, and Texas Department of State Health Services. The other authors report no conflict of interests or financial disclosures.
Funding Information:
Conflict of Interest: Dr. Kennard receives research support from the National Institute of Mental Health and royalties from Guilford Press. Dr. Foxwell receives royalties from Guilford Press. Dr. Emslie has received research support from Duke University and Forest Laboratories, Inc., and has been a consultant for Allergan, Assurex Health, Inc., INC Research Inc, Lundbeck, Neuronetics, Otsuka, Pfizer Inc, and Texas Department of State Health Services. The other authors report no conflict of interests or financial disclosures.
Publisher Copyright:
© 2018
PY - 2019/3
Y1 - 2019/3
N2 - Objective: Suicide is a leading cause of death in adolescents worldwide. There is an absence of effective and low cost treatment strategies for this growing public health problem. Current practice consists of brief hospitalization of acutely suicidal youth, but many get inadequate follow-up treatment. There are few alternatives to individual outpatient services offered at too low an intensity for an acutely distressed population. This paper describes the development, feasibility, acceptability, and preliminary clinical outcomes of an intensive outpatient program (IOP) for suicidal adolescents over a two-year period. Method: 364 eligible adolescents (12–18 years) who had a worsening of suicidal ideation or a suicide attempt were enrolled in an IOP and attended at least 1 group session. Depressive symptoms and suicidality were assessed at baseline and discharge from the program and at one and six month follow-up. Results: The majority of patients completed the IOP (81.0%; average of nine sessions). Over 95% of teens and parents responded that they were mostly or very satisfied with the IOP. The condition of patients improved at the time of discharge on depressive symptoms and suicidal ideation and behavior. 286 of the 364 youth (78.6%) completed the six-month follow-up. In total, 8.7% and 27.3% of the 286 respondents reported a suicide attempt and event, respectively, within six months of discharge from the IOP. Conclusions: While limited by the lack of a control group, our findings suggest that an IOP for adolescents with suicidality is acceptable and feasible as either a step-down from or an alternative to inpatient treatment.
AB - Objective: Suicide is a leading cause of death in adolescents worldwide. There is an absence of effective and low cost treatment strategies for this growing public health problem. Current practice consists of brief hospitalization of acutely suicidal youth, but many get inadequate follow-up treatment. There are few alternatives to individual outpatient services offered at too low an intensity for an acutely distressed population. This paper describes the development, feasibility, acceptability, and preliminary clinical outcomes of an intensive outpatient program (IOP) for suicidal adolescents over a two-year period. Method: 364 eligible adolescents (12–18 years) who had a worsening of suicidal ideation or a suicide attempt were enrolled in an IOP and attended at least 1 group session. Depressive symptoms and suicidality were assessed at baseline and discharge from the program and at one and six month follow-up. Results: The majority of patients completed the IOP (81.0%; average of nine sessions). Over 95% of teens and parents responded that they were mostly or very satisfied with the IOP. The condition of patients improved at the time of discharge on depressive symptoms and suicidal ideation and behavior. 286 of the 364 youth (78.6%) completed the six-month follow-up. In total, 8.7% and 27.3% of the 286 respondents reported a suicide attempt and event, respectively, within six months of discharge from the IOP. Conclusions: While limited by the lack of a control group, our findings suggest that an IOP for adolescents with suicidality is acceptable and feasible as either a step-down from or an alternative to inpatient treatment.
KW - Adolescents
KW - Intensive outpatient program
KW - Program development
KW - Suicide prevention
UR - http://www.scopus.com/inward/record.url?scp=85057224760&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057224760&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2018.09.015
DO - 10.1016/j.jadohealth.2018.09.015
M3 - Article
C2 - 30502117
AN - SCOPUS:85057224760
SN - 1054-139X
VL - 64
SP - 362
EP - 369
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 3
ER -