Our program is dedicated to developing, evaluating, and fine-tuning 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 involving over 300 suicidal youth and their families.
As you will read on our web page titled YST Intervention, YST is a psychoeducational, social network intervention for suicidal youths. Its goals are to improve youths' perceptions of social support, adherence with recommended treatments, and mental health outcomes. The YST "idea" grew from both clinical experience with suicidal youths and a careful review of the empirical literature on suicidal youth, prevention science, and treatment research. The YST intervention truly springs from a "scientist-practitioner" approach.
Many suicidal youth feel out of control in their lives. In addition, many of these youth are isolated from or in substantial conflict with significant others in their lives. YST is a multi-systemic intervention involving support persons from home, school, neighborhood, and community settings. It is also developmentally sensitive in its effort to empower youth by having the youth themselves nominate participating support persons. YST was designed as a supplement to "usual" mental health services following psychiatric hospitalization. It provides psychoeducation and weekly supportive contact to the youth's team of support persons. These support persons, in turn, support each participating youth's progress toward treatment goals and encourage treatment adherence.
We have learned a tremendous amount about YST from our large feasibility study. This was a randomized controlled clinical trial comparing Treatment-As-Usual (standard psychiatric and psychological treatments) to Treatment-As-Usual plus YST. From this study, we have learned that youth and their families are comfortable with and accepting of the YST intervention. We have learned that most nominated support persons do participate, attend YST psychoeducation sessions, and contact youth on a somewhat regular basis. We have learned that YST works best with teams of adult support persons. And, perhaps of greatest importance, we have learned that YST is promising in terms of improved outcomes for many suicidal youth. [Please see sections on Recent Activities and Publications and Presentations for more information on program findings thus far.]
With these encouraging findings as a backdrop, we plan to continue to develop and study YST. There are still many unanswered questions. What are the long-term effects of YST? How can we improve the intervention? How can we improve effectiveness with boys? Does YST positively impact suicidal youths' treatment adherence? Does it result in a change in youths' perceptions of social support?
Additional studies planned at this time include a one- to three-year follow-up of our 300 initial YST study participants. This project is currently underway. We also plan a new YST efficacy study involving a revised intervention manual, more extensive measures of youth functioning, and a longer follow-up period. Our work continues! Please stay tuned as we will share new findings and intervention materials with you on this website as they become available.
Acknowledgements
I would like to acknowledge the financial support from Ronald McDonald House Charities that has continued to make this clinical research and intervention program a reality. This support made it possible to grow an idea, further develop it with the help of experienced clinicians and scientific consultants, and test it in a large feasibility study. I also thank the YST Clinical Intervention Specialists who helped develop detailed implementation guidelines, shared many good ideas for the intervention manual, conducted countless psychoeducation sessions, made hundreds of follow-up phone calls to support persons, and maintained a sense of comraderie throughout. Many individuals - hospital and agency administrators, child psychiatrists (especially Paul Quinlan, Sanjeev Venkataraman, Preeti Venkataraman, Mohammad Ghaziuddin), research assistants (especially Sureyya Iscan, Carolyn LePan, Neshe Sarkozy),and consultants dedicated their time and energy to the success of this project.
Finally, a special thanks to Anne Kramer, M.S.W. (Lead Clinical Intervention Specialist and YST Intervention Manual co-author), Lesli Preuss (Postdoctoral Fellow, YST data analyst, and YST Intervention Manual co-author), Jean Pletcher (Program Assistant) and the many participating youths and families.