Safety Planning Juvenile Justice



Status:Recruiting
Conditions:Psychiatric, Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:12 - 17
Updated:2/2/2019
Start Date:January 1, 2019
End Date:October 31, 2021
Contact:Anthony Spirito, PhD
Email:anthony_spirito@brown.edu
Phone:401-444-1929

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Screening and Brief Intervention for Suicidality and Nonsuicidal Self-Injury Among Youth in the Juvenile Justice System

This study will examine the feasibility and acceptability of a program designed to conduct
safety planning with youth in the juvenile justice system who are at risk for a suicide
attempt and/or self-injury and to increase the possibility of them receiving outpatient
mental health treatment. After training staff in the intervention, the investigators will
pilot test the safety planning intervention and gather information on how well it worked on
reducing self-harm, getting families to follow up with referrals for mental health care, and
how often they attend treatment.

The Juvenile Justice System (JJS) has not implemented any evidenced-based interventions that
address suicidal behavior or nonsuicidal self-injury, hereafter referred collectively to as
self-injury, with JJS-involved youth. This application proposes to test a scalable
intervention, safety planning, that aims to reduce self-injury in adolescents involved in the
JJS. Safety planning, which can be a stand-alone brief intervention, was cited as a best
practice by the Suicide Prevention Resource Center/American Foundation for Suicide Prevention
Best Practices Registry for Suicide Prevention. This study will have two phases. In Phase I,
the investigators will conduct an open trial with 10 adolescents which will allow us to make
any modifications necessary for using the protocol in a Probation Department. The
investigators will then randomize 60 youth on Probation who screen positive for recent
self-injury into standard care or the safety planning intervention. Counselors with community
mental health experience embedded in Probation will conduct the intervention, consistent with
the co-responder model found across JJS in the U.S. in which a Probation Officer works
collaboratively with a mental health professional to coordinate care. In order to further
conduct the study under conditions most relevant to a future implementation trial, the
investigators will also employ a training approach that has been successfully implemented in
a psychiatric hospital with Bachelors and Masters level staff. In Phase II, of the study, the
investigators will: a) conduct qualitative interviews in Probation about attitudes toward the
intervention as well as barriers to a future, larger implementation trial; and b) contract
with the National Center for Mental Health and Juvenile Justice to conduct a Sequential
Intercept Model (SIM) Mapping. The SIM is a conceptual framework to outline a series of
"points of interception" along the JJS continuum in a state where screening and brief
intervention may be implemented. In the Mapping, the investigators will examine the JJS
continuum from arrest; to an initial hearing; to jail awaiting trial or adjudication;
incarceration; to release or reentry; and finally, to community supervision. These data will
provide a working framework to help assess current views within the statewide JJS as a
starting point to proposing a future, larger trial. This research also has the potential to
directly inform treatment practices in JJ settings and has significant implications for
scalability and dissemination in order to build a stronger, more effective system of mental
health/JJS collaboration around self-injury screening and intervention.

Inclusion Criteria:

- Legal guardian available to consent for juvenile's participation

- Juvenile and parents are English or Spanish speaking

- Juvenile flags in on the screening measure used in court with respect to suicidal
ideation or nonsuicidal self-injury.

Exclusion Criteria:
We found this trial at
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Providence, Rhode Island 02912
Principal Investigator: Anthony Spirito, PhD
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Providence, Rhode Island 02903
Phone: 401-793-8269
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