RESUMO
OBJECTIVE: We present results from a two-site, randomized clinical trial to assess efficacy of a brief intervention (As Safe As Possible; ASAP), a safety plan phone application (BRITE) and their combination on suicide attempts, suicidal ideation, non-suicidal self-injury, re-hospitalizations and suicidal events among adolescents. METHOD: Adolescents (n= 240; ages 12-17) hospitalized for suicidal ideation with plan and/or intent, and/or suicide attempt were assigned to one of four treatment conditions in a 2 by 2 design: ASAP+BRITE app+treatment as usual (TAU); (2) BRITE+TAU; (3) ASAP+TAU; and (4) TAU alone. Independent evaluators assessed suicidal ideation and behavior at 4, 12, and 24 weeks using the Columbia Suicide Severity Rating Scale (C-SSRS) and rehospitalization using the Child and Adolescent Services Assessment (CASA). RESULTS: No group differences were found on primary outcomes, except ASAP participants were less likely to be rehospitalized over 6 months (15.6%, vs. 26.5%, p=0.046). Participants hospitalized for an attempt and assigned to BRITE had a lower rate of subsequent attempts (OR=0.16, p=.01) and greater time to attempt (HR=0.20, p=.02). ASAP+BRITE, while not statistically significant, was most consistently associated with a reduction in suicide attempts (60% reduction). CONCLUSION: ASAP, BRITE, and their combination are equally effective at decreasing risk for suicidal events 6 months post-hospital discharge among suicidal adolescents; the ASAP intervention (with or without BRITE) was associated with lower rates of re-hospitalization. The BRITE app in youth hospitalized for suicide attempt had promising outcomes on future attempts.
