YST is an intervention designed to help suicidal adolescents after hospitalization.
It is a psychoeducational, social network intervention. In keeping with our strong belief in the importance of developing empirically validated interventions for these youth, we are completing a large scale, randomized controlled clinical trial to evaluate the effectiveness of YST. This trial involves two psychiatric hospitals and a community mental health agency. Our initial findings are promising; however, our plan is to continue to develop, fine-tune, and empirically evaluate this intervention.
YST targets two problems that characterize many psychiatrically hospitalized suicidal adolescents, poor treatment adherence and negative perceptions of family and social support. The intervention targets these problems during a period of particularly high risk, the first 12 months following hospitalization for serious suicidal thoughts, active suicidal intent, and/or a suicide attempt.
(a) Increase suicidal adolescent's perceptions of adult social support;
(b) Increase suicidal adolescent's adherence with recommended treatments;
(c) Decrease severity of suicidal ideation, depression, and anxiety;
(d) Improve adaptive functioning and prevent suicide attempts.
YST offers psychoeducation for youth-nominated caring adults, helping them to understand the adolescent's difficulties and treatment needs. These adults become YST support persons. YST is multi-systemic in its inclusion of nominated adults from home, school, and community setting, and its facilitation of regular contact between these adults and the adolescent. It is developmentally sensitive in its effort to positively empower and involve suicidal youth, giving them a "say" in their treatment, through the nomination of caring adults for participation.
YST provides psychoeducation and ongoing consultation for nominated support persons to help them (1) understand the adolescent's psychiatric disorder(s); (2) recognize "red flags" for increased suicide risk, and (3) support the adolescent's adherence with recommended treatments and progress toward treatment goals. It also facilitates ongoing communication between the suicidal adolescent and nominated caring adults from family, school, and community settings.
What takes place during the YST intervention?
Adolescents are asked to nominate four adults from their family, school and community to function as support persons when they leave the hospital. The YST Intervention Specialist helps adolescents with the nomination process and with contacting the nominated support persons. If they choose to participate, the support persons attend a psychoeducation session that focuses on the adolescent's psychiatric disorder(s), individualized treatment plan, suicide risk factors and ways to access emergency services. Support persons maintain regular contact with the adolescent to support treatment adherence and progress toward their treatment goals. The YST Intervention Specialist maintains regular telephone contact with each support person to provide information and address concerns. Thus, a supportive social network is established.
YST is designed to be a supplement to traditional or usual treatments (e.g., medication, therapy). The YST support person is not expected to serve in a professional capacity but to provide support, encourage treatment adherence, and understand how to access emergency services.
What is the Role of the Intervention Specialist?
The Intervention Specialists are mental health professionals responsible for recruiting YST youth participants. They are responsible for working with youth and families to identify the youth-nominated support persons, conducting the YST psychoeducation sessions, and conducting telephone check-ins (e.g., weekly contact with youth support persons, monthly contact with youth and family, contact with treatment provider). These check-ins are for the purpose of supporting youth, encouraging adherence to treatment recommendations, and monitoring youth's progress. Intervention Specialists will also be aware of the importance of monitoring adolescents' risk status.
For Additional Information
Cheryl A. King, Ph.D.
Project Director
Department of Psychiatry
University of Michigan Medical School
1500 E. Medical Center Drive
Ann Arbor, MI 48109-0295
(734) 764-3168
Email: kingca@umich.edu