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The Cutting Edge

Tracking Teen Suicide

WITH NEARLY 36,000 PEOPLE TAKING THEIR OWN LIVES IN THE U.S. EACH YEAR, more than 4,600 of those victims are between the ages of 10 and 24, making suicide the third leading cause of death in this age group. And though youths treated at hospital emergency rooms for suicidal behavior remain at very high risk for future suicide attempts, many don't receive the follow-up care they need after discharge.

Now, a new study by UCLA researchers shows that a specialized mental-health intervention for suicidal youth can help. Reporting in the journal Psychiatric Services, Joan Asarnow, Ph.D., professor of psychiatry at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues show that a family-based intervention conducted while troubled youths are being treated in the hospital emergency department (ED) can lead to dramatic improvements in linking these youths to outpatient treatment following discharge.

"Because a large proportion of youths seen in the ED for suicide don't receive outpatient treatment after discharge, the United States National Strategy for Suicide Prevention identifies the ED as an important suicide-prevention site," says Dr. Asarnow. "So, a national objective is to increase the rates of mental-health follow-up treatment for suicidal patients coming out of EDs."

But how does one encourage this follow-up when youth are at their most vulnerable? Those in the study were randomly assigned to either the usual ED treatment or an enhanced mental-health intervention. The latter involved a family-based crisis-therapy session designed to increase motivation for outpatient follow-up treatment and improve the youths' safety, supplemented by telephone contacts aimed at supporting families in linking to further outpatient treatment.

The results of the study show that the enhanced mental-health intervention was associated with higher rates of follow-up treatment. Of the participants in the enhanced intervention, 92 percent received follow-up treatment after discharge, compared with 76 percent in the standard ED treatment arm — a clinically significant difference.

While the results are positive, the study is only a first step. "The results underscore the urgent need for improved community outpatient treatment for suicidal youths," Dr. Asarnow says. "Unfortunately, the follow-up data collected at about two months after discharge did not indicate clinical or functioning differences among youths who received community outpatient treatment and those who did not."


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