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Youth Depression and Suicide Prevention Program Research Initiatives

Adolescents Seeking Emergency Services: Suicide Risk Detection and Treatment Facilitation
Project Director:  Cheryl King, PhD;
Project Coordinators:  Melissa Webster, LMSW; Anne Kramer, LMSW

We are developing a theoretically-driven intervention, Teen Options for Change (TOC). We designed this intervention to emphasize earlier detection and treatment facilitation for adolescents who seek emergency services and present with known suicide risk factors. TOC incorporates motivational interviewing principles and is based on health behavior promotion models.  This project capitalizes upon our interdisciplinary team’s substantial research experience in (a) clinical research with suicidal adolescents, (b) motivational interviewing intervention research, (c) the development of culturally tailored intervention materials, and (d) emergency-based interventions for alcohol misuse. As the recipient of an NIMH-funded R34 Exploratory Research Project, Dr. King and her team will further develop and pilot test the TOC intervention with disadvantaged urban adolescents who seek emergency services and present with known risk factors.

Youth-Nominated Support Team Intervention for Suicidal Adolescents
Project Director: Cheryl King, PhD;
Project Coordinator:  Anne Kramer, LMSW

Our program is dedicated to developing and examining the efficacy of a new intervention for suicidal youth, the Youth-Nominated Support Team (YST). Our initial efforts were made possible by Ronald McDonald House Charities.  With their financial support we were able to involve six sites - two psychiatric hospitals and four community mental health agencies - in developing intervention guidelines and implementing a large feasibility study. Since that time, funding from the National Institute of Mental Health (NIMH) has made it possible for us to implement a larger and more scientifically rigorous study of the Youth-Nominated Support Team Intervention for Suicidal Adolescents Version II (YST-II). We involved two psychiatric hospitals and included over 400 suicidal youth and their families in this randomized controlled clinical trial.  Our large clinical sample with data from multiple youth assessments across a 12-month period also enables us to contribute new findings related to the evidence-based risk assessment of suicidal youth.  Data collection for this study is complete.  We are now involved in the preparation and publication of study findings.

SAMHSA-Transforming Youth Suicide Prevention
Project Director: Cheryl King, PhD;
Project Coordinator: Melissa Webster, LMSW

Members of our research team, funded by the state of Michigan, are the evaluation consultants for the Transforming Youth Suicide Prevention Program (TYSP). Funding to the state of Michigan comes from the Garrett Lee Smith Memorial Act, signed into law in October, 2004, which authorizes the use of funds to support States, Indian tribes and colleges and universities to develop and implement various youth suicide prevention initiatives. Our researchers provide the expertise and oversight of the required self-evaluation component for this project. Dr. King consults regularly with the Project Director, Patricia Smith, and Ms. Webster has consulted directly with each of the six Michigan communities that have received suicide prevention funds from this grant.

Depression Awareness and Stigma Reduction in African American Youth
Project Director: Cynthia Ewell-Foster, PhD; cjfoster@umich.edu

The primary goal of this project, funded by the Aetna Foundation, is to provide an effective public education and mental health awareness program to underserved, low-income, minority youth.  This project will be one of the first research initiatives to employ rigorous scientific methods to examine the effectiveness of a brief school-based intervention for the reduction of mental illness stigma. The intervention we are studying is MINDS (Mental Illness Needs Discussion Sessions Program) and includes: (1) a personal testimonial of experience with mental illness, (2) information about mental illness and its effective treatment, (3) refutation of stigmatizing myths about mental illness, and (4) information about treatment resources in the community.  Our primary goals are to refine this intervention with the assistance of a Mental Health and Stigma Experts Panel and a Community Advisory group, and to conduct a pilot randomized controlled trial to determine its feasibility, acceptability, and potential efficacy. 

Improving Patterns of Physical Activity and Sleep in Youth with Depression
Project Director: Rich Dopp, MD; dopp@umich.edu

           
Physical activity and sleep have been linked to depressive symptoms in multiple populations. Persistent sleep disturbance increases the risk for recurrence of major depressive episodes and is the most common residual symptom in adolescents who fail to achieve remission of depression. Furthermore, recent work has shown that depressed children and adolescents have lower activity levels that are strongly related to impaired sleep regulation.  Working with other members of the research team, including Dr. Cheryl King and Dr. Roseanne Armitage, Dr. Dopp plans to explore the mental health benefits of physical activity and healthier sleep cycles for the treatment of adolescent depression. Dr. Rich Dopp is the recipient of the Rachel Upjohn Scholars Award and a Kingenstein Foundation Third Generation Fellowship Award. 

STAR*D-CHILD
Project Director (Michigan): Cheryl King, PhD;
Project Coordinator:  Melissa Webster, LMSW;

STAR*D-Child is an ancillary study to the STAR-D multi-site study (Strategic Treatment Alternatives to Relieve Depression).   The purpose is to study the impact of maternal depression-remission on children’s symptoms, behavior and social functioning.   The aims of this study are to: (1) compare the outcomes of children whose mothers spend more versus less time in depression-remission, (2) compare the outcomes in children of mothers who experience and do not experience depression-remission, and (3) determine the temporal relationship between maternal changes in levels of depression (as assessed by HAM-D17 scores) and changes in children (psychiatric symptoms and social functioning).  Data collection for this study is complete.  The multi-site project team is currently involved in the preparation and publication of study reports.

Innovative Treatment Enhancements for Depressed Youth
Project Director: Cheryl King, PhD;
Project Coordinator:  Melissa Webster, LMSW;

With a focus on the importance of improved treatment adherence and psychiatric outcomes among depressed youth, we are examining clinical outcomes and treatment utilization of clinically depressed adolescents. Our primary aims have included: 1) to assess outcomes associated with a clinical monitoring system for adolescents with depressive disorders, 2) to examine predictors of treatment utilization and adherence among these youth, 3) to identify predictors of the longitudinal course of depression.  This work was made possible with funds from Blue Cross Blue Shield of Michigan and the Flinn Foundation. We have utilized and evaluated the advantages of a computerized interactive voice recognition (IVR) system, a relatively new assessment tool for the weekly monitoring of depression.