A Randomized Controlled Trial of a Cellphone-Based Intervention to Promote Lethal Means Safety in Suicidal Adolescents
The prevalence of youth suicide is a significant public health concern. Lethal means restriction is the practice of removing potentially dangerous items from a suicidal individual's environment to promote safety. It is widely accepted that lethal means restriction is a best practice for the prevention of suicides, though the bulk of the evidence supporting this practice comes from ecological studies of population-level changes in suicide mortality rates. Phone-based interventions provide easily accessible, inexpensive means of influencing health behaviors. The primary aim of the present study was to evaluate the feasibility, acceptability, and user satisfaction of a novel text message-based intervention (Safe Home) designed to promote adherence to lethal means restriction practices among caregivers of adolescents discharged from an intensive outpatient suicide prevention program. Exploratory aims included evaluating the efficacy of the intervention at reducing suicide attempts and events among adolescents and investigating the adolescent's perception of their access to lethal means. Participants in this investigation included 40 adolescent-caregiver dyads recruited from the Suicide Prevention and Resilience at Children's (SPARC) intensive outpatient program. Families were randomized to receive either treatment as usual or the novel intervention for one month beginning at the adolescent's discharge from the SPARC program. Data were collected at the consent visit and at one-month post-discharge. Results indicated hypotheses regarding the feasibility of the intervention were partially supported and the intervention was acceptable and satisfactory to participating caregivers. Regarding exploratory aims, no significant differences were found between the two experimental groups. The development and evaluation of the novel Safe Home intervention addressed a gap in the literature regarding experimental investigations of lethal means restriction interventions.
Health Behavior, Health Knowledge, Attitudes, Practice, Suicidal Ideation, Suicide Prevention, Suicide, Attempted, Young Adult, Adolescent
University of Texas Southwestern Medical Center
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