Hughes Lab

Suicide rates among U.S. adolescents have risen to the highest level in more than a decade. For youth at high risk of suicide, inpatient psychiatric hospitalization has been recommended when safety in the community is unmaintainable. However, access to these services has decreased over the last several decades as the availability of inpatient psychiatric beds for adolescents has steadily declined. Against this backdrop, inpatient admissions for suicidal behavior and intentional self-injury among youth more than doubled between 2006 and 2015. In many communities, the demand for, and limited access to inpatient psychiatric care has created a need for other options to provide short-term crisis intervention and stabilization in a secure setting.

Intensive Crisis Intervention (ICI) has been developed as a novel treatment for adolescents experiencing suicidal crises in response to the limited resources available for adolescents with acute psychiatric concerns. As one of the NIMH P50 ASPIRES Center exploratory projects, this study’s primary objective is to refine and test ICI for suicidal adolescents as an alternative to psychiatric hospitalization.

EP2 - ICI is funded by the NIMH P50 ASPIRES Center.

Youth suicide is a major public health problem, and suicide is the 3rd leading cause of death among 10–24-year-olds in the US. Parents and primary caregivers have a significant role in youth suicide prevention, including recognizing the signs of suicidal thoughts or behaviors, supporting their child during suicidal crisis, seeking care for their child and fostering a strong, loving relationship (an important protective factor). Studies have demonstrated the importance of families in youth suicide interventions, yet clinicians often have limited guidance on how to best engage parents in the safety planning and intervention process with suicidal youth.

This study aims to adapt the parent component of Safe Alternatives for Teens and Youth (SAFETY) outpatient intervention to SAFETY-Parent (SAFETY-P), a self-paced interactive learning module for parents, to be implemented as an augmentation for youth being seen for suicidal ideation, suicidal behavior, or recent suicide attempts.

SAFETY-P is funded by the American Foundation for Suicide Prevention (AFSP).

Adolescence is a critical period of psychological and biological change, when sleep health problems affect 50 to 60 percent of adolescents. Sleep health problems exacerbate difficulties with mental health, physical health, daily functioning, depression, attention deficit hyperactivity disorder, anxiety, suicidal and self-harm behavior, obesity and poor school performance. Taken together, sleep health problems are an important contributor to and a possible cause of vicious cycles of escalating vulnerability and increased risk among youth.

In collaboration with Dr. Lauren Asarnow (Children’s Hospital Los Angeles) as co-principal investigator, the research team will compare the effectiveness of two evidence-based school-friendly interventions among youth ages 12 to 18 in middle and high schools in Ohio and California. Evaluating the two approaches to sleep health treatment in schools, a setting where most youth spend large portions of their days, will allow the project to examine the benefits of these treatments in a setting with the possibility of offering near universal access to treatment for students, including vulnerable students who face systemic, personal and other barriers to treatment.

This project is funded by the Patient-Centered Outcomes Research Institute (PCORI).

There is a need for alternative treatments for adolescent depression. Despite increased prevalence, the number of adolescents receiving treatment has largely remained stable, resulting in many more untreated cases. Testing alternative approaches to treating depression in adolescents, including interventions that do not rely on the limited pool of adolescent mental health providers, and can be administered concomitant with other treatments, is an urgent public health priority.

Yoga-based interventions (YBIs) have shown promise for adult depression. A 2020 systematic review of studies of youth demonstrated YBI’s association with decreased depressive symptoms in school-based programs and in programs for adolescents with other health conditions. Led by Co-PIs Dr. Lisa Uebelacker (Brown University, Butler Hospital) and Dr. Shirley Yen (Harvard Medical School, Beth Israel Deaconess Medical Center), this project aims to develop strategies to increase inclusion of and acceptability of depression treatments to teens with a variety of identities and to conduct a pilot RCT of a YBI vs. group cognitive behavioral therapy (gCBT) at study sites in Columbus, OH and Boston, MA.

Teenthrive 2 is funded by the National Center for Complementary and Integrative Health (NCCIH).

Youth suicide prevention efforts have been integrated into community settings such as schools. Schools are an ideal setting for early identification of mental health needs, provision of intervention services and implementation of prevention strategies. Youth Aware of Mental Health (YAM) is a manualized, universal, school-based mental health promotion and suicide prevention program for youth ages 14-16. While initial feasibility and acceptability of YAM are promising, widespread implementation of the program in the U.S. has been limited and future studies are needed to better understand the challenges and to optimize methods for widespread delivery of YAM. Also, identifying barriers and facilitators to implementing YAM in classrooms will also provide needed guidance on how to best implement other universal suicide prevention programs in schools. One approach to understanding these challenges and potential solutions is the RE-AIM framework, which highlights aspects in the design, dissemination and implementation process that relate to achieving broad and equitable population-based impact.

This research project addresses the urgent need to optimize methods for the widespread adoption, implementation and maintenance of universal suicide prevention programs in schools to reduce youth suicide risk.

The YAM RE-AIM Pilot is funded by the NIMH P50 ASPIRES Center Pilot Program.