Mobile Crisis for Suicidal Youth

Suicide is the second leading cause of death among children ages 10-14, with a 240 percent increase in females and 74 percent increase in males between 1999 and 2017. Similar trends are seen across adolescent age groups, with suicidal ideation increasing sharply during adolescence. Mobile crisis (MC) services, which have been promoted by leading national models for suicide prevention such as the Zero Suicide (ZS) Initiative and Crisis Now model, have been recognized as playing a key role in suicide prevention. MC teams are available in 48 states in the U.S. and have been shown to reduce psychiatric inpatient utilization and health system costs. However, little is known about best practices for suicide prevention in the unique context of MC, especially for youth populations. There is an urgent need for examining current MC practices, since they routinely provide care for youth at acute risk of suicide. 

To fill this gap, this proposal aims to link three large clinical databases to describe referral patterns among individuals age 17 and younger with suicidal symptoms who utilized Georgia's statewide crisis call center (n=19,733) and MC team (n=12,348) from 2016 to 2018. In Aim 1, Dr. Goldman seeks to determine if suicide symptom severity is associated with level of care recommendations for youth accessing a statewide crisis system. In Aim 2, Dr. Goldman will analyze these crisis records to identify demographic and socioeconomic factors associated with referral to different levels of care among youth with suicidal symptoms. The rationale for these analyses is that if certain vulnerable groups of children and adolescents are referred differently when experiencing suicidal symptoms, the MC visit may be the only immediate opportunity for suicide prevention if they have less access to crisis stabilization units (CSUs) or inpatient psychiatry. Identification of these groups would have direct implications for clinical practice by informing the development of strategies to reduce biased decision-making as part of youth suicide prevention best practices in crisis settings. The results of this research will advance suicide prevention in crisis services and will directly inform the development of an adapted ZS model that will be used in MC settings.