e-Connect for Suicide Prevention in Youth

Overseen By Katherine S Elkington, Ph.D.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: New York State Psychiatric Institute

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program called e-Connect to identify and support youth at risk of suicide, particularly those in the justice system. Researchers are implementing it in nine counties in Indiana to determine if it performs as well as it did in a previous study in New York. The trial will compare the new e-Connect approach to the usual care provided in these counties. Youth on probation and staff from probation and treatment agencies in these counties are encouraged to participate. This is an opportunity to contribute to significant advancements in youth mental health support. As an unphased trial, this study offers a unique chance to contribute to innovative mental health solutions for at-risk youth.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this program is safe for justice-involved youth?

Research shows that e-Connect is a program designed to help young people in the justice system by identifying those at risk of suicide and connecting them to appropriate services. Studies have shown that e-Connect uses proven methods to assess suicide risk, relying on solid data for decision-making.

Findings so far suggest that e-Connect is safe to use in this setting. Studies have reported no harmful side effects or negative experiences, indicating that young people handle the program well. The program has effectively improved the use of safety plans and increased youth confidence in avoiding harmful actions.

In summary, the available data supports that e-Connect is safe and useful for helping at-risk youth in the justice system without any reported negative effects. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard practice of care, which often involves traditional counseling and medication approaches, e-Connect is unique because it focuses on early intervention and digital connectivity to prevent youth suicide. This method leverages technology to provide timely support and resources, potentially reaching young people in their everyday environments more effectively. Researchers are excited about e-Connect because it could bridge the gap between at-risk youth and immediate help, offering a proactive approach rather than a reactive one. This innovative strategy aims to enhance accessibility and engagement, which could significantly improve outcomes for young individuals struggling with suicidal thoughts.

What evidence suggests that e-Connect is effective for suicide prevention in youth?

Research has shown that e-Connect, which participants in this trial may receive, effectively identifies and connects at-risk youth in the justice system to necessary support. Studies indicate that e-Connect can accurately assess suicide risk, enabling timely intervention. In past research, this system outperformed standard probation methods in detecting suicidal behavior and connecting young people to appropriate treatments. Although some users express concern about relying solely on technology during crises, the overall design supports effective risk assessment and intervention. This tool aids probation officers in identifying signs of suicidal thoughts, mental health issues, and substance use problems, leading to more comprehensive care. ^{1 2 5 6 7}

Are You a Good Fit for This Trial?

This trial is for probation agency leadership and officers at least 18 years old who speak English, working in the partnering sites of the study's Indiana counties. There are no specific exclusion criteria or special classes of participants.

Inclusion Criteria

I am a youth on probation, aged 10-18, and speak English.

Exclusion Criteria

There are no exclusionary criteria and no special classes of participants.

Timeline for a Trial Participant

Scale-Up Strategy Efforts

Focused on preparing for scale-up of the e-Connect program

1 year

e-Connect-scaleup Implementation

Implementation of e-Connect in juvenile probation settings, including Exploration and Preparation, and Implementation and Sustainment

2 years

Scale-Up Effectiveness Trial/Outcome Evaluation

Evaluation of the effectiveness of the e-Connect scale-up, including clinical and cost-effectiveness assessments

1 year

Follow-up

Participants are monitored for the sustainability and fidelity of the e-Connect implementation

1 year, 4 months

What Are the Treatments Tested in This Trial?

Interventions

• e-Connect

Trial Overview The trial is testing e-Connect, a program designed to identify suicide risk and behaviors among justice-involved youth and link them across systems. It involves preparing for scale-up, implementing e-Connect in new settings, and evaluating its effectiveness over three phases.

How Is the Trial Designed?

Group I: e-Connect Experimental Treatment 1 Intervention

County receives training and materials and subsequently begins the e-Connect intervention

Group II: Standard of Care Active Control 1 Intervention

Standard of care practice in counties prior to the implementation of e-Connect

Who Is Running the Clinical Trial?

New York State Psychiatric Institute

Lead Sponsor

Trials

481

Recruited

154,000+

Indiana University School of Medicine

Collaborator

Trials

194

Recruited

181,000+

Chestnut Health Systems

Collaborator

Trials

27

Recruited

24,500+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

George Mason University

Collaborator

Trials

60

Recruited

50,200+

Columbia University

Collaborator

Trials

1,529

Recruited

2,832,000+

Published Research Related to This Trial

In the ED-SAFE study, structured telephone follow-up assessments were crucial for identifying adverse events (AEs), detecting 45% of total AEs that were missed by chart reviews alone.

The detection of suicide attempts varied significantly by method, with structured follow-ups identifying 59% of attempts compared to only 18% through chart reviews, highlighting the importance of using multiple detection methods in suicide research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using structured telephone follow-up assessments to improve suicide-related adverse event detection. Arias, SA., Zhang, Z., Hillerns, C., et al.[2021]

The web-based adverse event tracking system (eAETS) has effectively supported 175 clinical protocols over four years, capturing 2,440 adverse event reports, including minor symptoms that could indicate serious issues.

Out of the reported AEs, 1,053 did not align with the initial risk profiles, leading to corrective recommendations in 13% of the protocols, highlighting the system's role in enhancing subject safety by identifying unanticipated patterns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of minor adverse event tracking on subject safety: a web-based system. Shenvi, NV., Gebhart, SS.[2009]

In a study of 181 youth suicide attempters in emergency departments, key factors influencing the decision to admit or discharge included the specific ED site, the presence of a suicide plan, and parental reports of problems.

Hospitalization was linked to better connections to outpatient treatment and increased use of intensive services, highlighting the importance of inpatient care for improving outcomes in high-risk youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors and Outcomes of Psychiatric Hospitalization in Youth Presenting to the Emergency Department with Suicidality. Hughes, JL., Anderson, NL., Wiblin, JL., et al.[2022]

A pilot study of a text-messaging intervention for youths discharged from the hospital after suicidal thoughts showed it was feasible and well-received, helping to reduce suicidal thoughts and behaviors.

The positive results of this intervention led to the Maryland Department of Health expanding the program to offer similar support to all Maryland residents, highlighting its potential effectiveness in suicide prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Brief Text-Messaging Intervention for Suicidal Youths After Emergency Department Discharge. Ryan, TC., Chambers, S., Gravey, M., et al.[2022]

The study involving 20 adolescents discharged from a mental health ward showed that the smartphone apps BeyondNow and BlueIce were feasible and acceptable, with most participants accessing them at least once during the six-week follow-up.

While many participants found the apps easy to use, a significant portion (47%) felt they would not ensure safety during a crisis; however, improvements in suicide resilience were noted, indicating potential benefits in managing self-harm and suicidal behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The feasibility of using smartphone apps to manage self-harm and suicidal acts in adolescents admitted to an inpatient mental health ward. Muscara, F., Ng, O., Crossley, L., et al.[2022]

A qualitative study involving experienced suicide researchers revealed significant challenges in defining and reporting adverse events (AEs) and serious adverse events (SAEs) in suicide prevention trials, which complicates safety evaluations.

Participants emphasized the urgent need for clear and consistent definitions and reporting standards for AEs and SAEs to improve the comparability of studies and enhance safety monitoring in at-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variability in the definition and reporting of adverse events in suicide prevention trials: an examination of the issues and a proposed solution. Oquendo, MA., Feldman, S., Silverman, E., et al.[2022]

Citations

1. sciencedirect.com sciencedirect.com/science/article/pii/S2949732925000468

Predictive Validity of the e-Connect Suicide Risk ... This paper evaluates the predictive validity of a close analogue of this algorithm for predicting STBs over the 12 months following assessment.

2. withpower.com withpower.com/trial/phase-suicide-2023-421b3

e-Connect for Suicide Prevention in Youth While many participants found the apps easy to use, a significant portion (47%) felt they would not ensure safety during a crisis; however, improvements in ...

3. jaacapopen.org jaacapopen.org/article/S2949-7329(25)00046-8/pdf

Predictive Validity of the e-Connect Suicide Risk ... Conclusion: Results showed strong predictive validity of the tiered risk classification algorithm, and support its use in probation settings for effective.

4. chestnut.org chestnut.org/li/research-and-evaluation-projects/profile/scaling-up-econnect-in-juvenile-probation-settings-a-hybrid-implementation-effectiveness-trial-of-a-digital-suicide-risk-behavior-identification-and-linkage-to-treatment-system-e-connect-in

Scaling up eConnect in Juvenile Probation Settings The e-Connect software allows Probation Officers to screen youth for suicidal behavior, behavioral health, and substance use problems using a modified GAIN ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10526689/

e-Connect: Linking Probation Youth at Risk for Suicide to ... This study presents a system-level intervention design and compares system performance outcomes in e-Connect (intervention) to standard probation officer ...

6. psycnet.apa.org psycnet.apa.org/record/2023-78404-001

E-Connect: Linking probation youth at risk for suicide to ... Objective: Youth involved in the justice system (YIJ) have higher rates of suicidal thoughts and behaviors (STB) and associated behavioral health (BH) ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12378765/

Suicide Prevention in Youth - PMC Adolescents who received supportive text messages showed improved safety plan use, self-efficacy to refrain from suicidal action, and coping by ...