A Multi-Site Study to Compare the Outcomes of Psychiatric Treatment of Suicidal Adolescents in Different Treatment Settings

Suicide is a leading cause of death for adolescents in the United States (US). Alternate settings to treat youth at risk for suicide are needed. This study aims to evaluate the effectiveness of novel Outpatient Crisis Intervention Clinics (OCIC) compared to inpatient psychiatric treatment for suicidal adolescents. The primary hypothesis is that OCIC will lead to a lower risk of suicidal events, defined as a suicide attempt, interrupted attempt, hospitalization because of suicidal risk, an emergency/urgent evaluation because of suicidal risk, or a death by suicide and higher treatment satisfaction (TS) and satisfaction with life (SL) for both patients and their caregivers. Specific hypotheses include that OCIC will delay the first recurrence of a suicidal event compared to inpatient treatment. Additional hypotheses include that OCIC will lead to a lower number of suicidal events over 4 and 12 weeks; that clinical and sociodemographic features will influence the response to OCIC or inpatient treatment; that OCIC will result in higher TS, better SL, and lower suicide severity scores compared to inpatient treatment. Procedures are that participants will be assigned to either OCIC or inpatient treatment. Data will be collected at baseline and up to 12 weeks post-ED visit. In terms of potential impact, the results of this study will provide critical insights into the effectiveness of OCIC as an alternative to inpatient psychiatric treatment for suicidal adolescents. This could lead to improved decision-making for families and clinicians, reduced burden on inpatient facilities, and better overall safety and outcomes for adolescents experiencing suicidality and their families. The results will pave the way for future research focusing on long-term outcomes of OCIC, exploring additional alternative treatments, and investigating the scalability of OCIC services across different regions and populations. In addition, the cost-effectiveness of OCIC compared to inpatient treatment will be evaluated through larger-scale studies.