Development and Preliminary Testing of a "Papageno" Story Interview Intervention

Suicide is the second leading cause of death for 18-24 year-olds in the US. As one preventive strategy, several organizations have published testimonials of previously suicidal individuals who found non-suicide alternatives (also known as "Papageno" stories) on their websites. However, the effectiveness of this strategy has not been examined empirically with an intentionally produced "Papageno" production. The specific aims of this study are: Aim #1: To develop and refine a Papageno-story interview intervention, we will film 5 interviews of young adults (age 18-24) who vary by age, gender identity, and race/ethnicity. Each individual will be asked questions about a time in their life when they took preparatory actions toward suicide, but then engaged in non-suicide alternatives. Interview questions will be directed to prompt interviewee responses that inspire hope, reasons for living, perceived agency and the belief that help is available. Aim #2: To determine acceptability of the filmed interviews, we will engage 12 community partners who vary by age (age 18-20, 21-24), gender identity (female, male, nonbinary/transgender), and race/ethnicity. Community partners will be asked to complete questionnaires about the acceptability of the intervention, their identification with the interviewee, and overall feedback.  Videos with high acceptability and community partner identification will be put forward for further testing in Aim #3.  Aim #3: To determine the potential suicide protective effects of a "Papageno story" interview on 18-24 year-olds, we will conduct a randomized controlled trial and query viewers at baseline, after viewing the taped interview, and at 3-month follow-up, through a web-based questionnaire assessing our outcomes. Our hypothesis is that the Papageno interview will outperform the active control in improvement of ratings on the Suicide Ideation Severity Scale of the C-SSRS, the Beck Hopelessness Scale-4 (BHS-4), the Brief Reasons for Living Inventory, the Perceived Control Scale and the single item question about their perception that help is available. Open-ended questions will also be posed post-intervention about acceptability of the intervention. Sample: Participants (n=1000; age 18-24) will be recruited from social media and include young adults who have past month history of suicidal ideation. Procedures: Participants will be randomly assigned to the Papageno story interview vs control; both videos will be approximately 30 minutes. They will complete a web-based questionnaire before the intervention, right after the intervention and then again 3 months after watching the films. They will also answer open-ended questions about the intervention that will be coded, and trends will be analyzed using a grounded theory approach. Pre, post and 3-month post questionnaires will be analyzed for effects of the Papageno film. Potential Impact: If a Papageno story intervention is found to be effective, it is highly scalable and could be administered in virtual spaces for a potentially widespread positive impact. Next Steps: These findings will be used to apply for a NIMH K-award to develop and empirically examine the effectiveness of a professionally produced Papageno story film.