Improving Care for Depression and Suicide Risk in Adolescents: Innovative Strategies for Bringing Treatments to Community Settings

Abstract

This article reviews the literature on interventions and services for depression and suicide prevention among adolescents, with the goals of placing this science within the context of current changing health care environments and highlighting innovative models for improving health and mental health. We examine the: challenges and opportunities offered by new initiatives and legislation designed to transform the U.S. health and mental healthcare systems; summarize knowledge regarding the treatment of depression and suicidality/self-harm in adolescents; and describe innovative models for partnering with health systems and communities. This review demonstrates that treatment models and service delivery strategies are currently available for increasing evidence-based care, particularly for depression, and concludes with recommendations for future research and quality improvement initiatives aimed at inspiring additional efforts to put science to work, bridge science and community practice, and develop strategies for partnering with communities to improve care, mental health, and well-being among adolescents.

Psychopathology profiles of acutely suicidal adolescents: Associations with post-discharge suicide attempts and rehospitalization

“…Youth suicidal behavior is difficult to predict and to prevent, particularly among high risk samples (Asarnow and Miranda, 2014; Brent et al, 2013). A substantial body of literature has documented that adolescents receiving higher levels of care such as emergency room visits and psychiatric hospitalization are likely to have a recurrences of psychiatric crises and suicide attempts up to a year following discharge, with the initial 3 months being particularly high risk (Troister et al, 2008).…”

“…Suicidal adolescents present for mental health treatment with substantial demographic and clinical heterogeneity, which challenges the development of efficacious treatments and preventative interventions (Asarnow and Miranda, 2014; Brent et al, 2013). Limited resources for mental health services necessitate efficient triage decisions for these youth regarding level of care and appropriately personalized follow-up care (Troister et al, 2008).…”

“…Limited resources for mental health services necessitate efficient triage decisions for these youth regarding level of care and appropriately personalized follow-up care (Troister et al, 2008). Above and beyond accumulative burden, understanding how multiple risk factors interact and co-occur may aid in the prediction of more imminent suicide-related outcomes (Asarnow and Miranda, 2014; Nock, 2010; Pena et al, 2012). …”

Open Trial and Pilot Randomized Controlled Trial of a Novel Program to Reduce Perceived Burdensomeness

“…Similarly, teachers and school counselors, already overburdened, may not have the time to personally intervene with such a large number adolescents. Any new program development targeting non-clinical suicide risk will need to take into account the feasibility of the developed treatment for dissemination and implementation in community settings (Asarnow & Miranda, 2014).…”

“…Leaders within the field of suicidology have called for additional attention to be given to innovative strategies for prevention and early intervention of suicide-related behaviors (Asarnow & Miranda, 2014).…”