BH-Works Suicide Prevention Program for Youth Suicide Risk

Recruiting at 4 trial locations

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Virginia Polytechnic Institute and State University

Disqualifiers: Limited English proficiency, comprehension issues

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

Compensation: Varies

Number of Visits: Unknown

260 Participants Needed

Trial Summary

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 data supports the effectiveness of the BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth treatment?

Research suggests that creating a supportive environment, such as a positive school climate, can help reduce suicide risk for sexual and gender minority youth. Additionally, interventions focusing on family support and acceptance have shown potential benefits in reducing suicide-related thoughts and behaviors in this group. ^{1 2 3 4 5}

How is the BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth different from other treatments for youth suicide risk?

The BH-Works Suicide Prevention Program is unique because it is specifically tailored to address the unique needs and risk factors of sexual and gender minority youth, a group that faces higher suicide risks compared to their peers. Unlike general interventions, this program focuses on creating supportive environments and addressing minority stress, which are critical for reducing suicide risk in this population. ^{1 2 6 7 8}

What is the purpose of this trial?

Youth suicide is a serious public health concern. Compared to their heterosexual and cisgender peers, sexual and gender minority (SGM) adolescents report higher rates of suicidal ideation and suicide attempts. Unfortunately, many barriers complicate the implementation of suicide prevention in SGM communities. SGM youth often report feeling unwelcome in traditional behavioral health service organizations. Consequently, treatment attendance and retention remain low. Instead, this population generally seeks mental health services in community organizations for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. These organizations are often unprepared for this clinical challenge. The Behavioral Health-Works (BH-Works) suicide risk management system may offer a potential solution to this problem. BH-Works is an evidence-based, comprehensive youth suicide prevention program. It offers support for policy development, staff training, suicide and behavioral health screening, technology-assisted safety planning, an electronic patient referral system, real-time data analytics for program monitoring, and a learning collaborative structure to support sustainability. All functions are supported on a web-based software platform that facilitates cross-system communication, implementation, adoption, and expansion. In this project, the investigators will adapt this program for LGBTQ organizations and test feasibility, acceptability and preliminary effectiveness. This project builds upon robust partnerships with two diverse LGBTQ organizations in Philadelphia, Pennsylvania and rural Southwest, Virginia) and their respective behavioral health (BH) partnering sites. To facilitate BH-Works adaptation for SGM adolescents, the investigators will employ the Enhancing Engagement trajectory from Lau's cultural adaptation framework. To pilot the program within LGBTQ organizations and their partners, the investigators will use an Effectiveness-Implementation Hybrid Type 2 design with a historical comparison group. Informed by the Consolidated Framework for Implementation Research, the investigators will also pilot test a sequenced implementation strategy. This strategy focuses on promoting engagement, building partnerships, and creating sustainability. In Years 1 and 2, the investigators will collect treatment as usual data, and work with their partners to adapt BH-Works policy, content, practices, and workflow. The investigators will also train staff/providers in suicide risk management, family engagement and affirmative care. In Years 3 and 4, the investigators will test the adapted SGM BH-Works Program and examine several essential program targets (training impact, partnership development, software usability) and outcomes (successful referral, program satisfaction, caregiver involvement, suicide identification).

Research Team

Jody M. Russon, PhD

Principal Investigator

Virginia Polytechnic Institute and State University

Eligibility Criteria

This trial is for young individuals who are part of the sexual and gender minority (SGM) community, currently experiencing suicidal thoughts, and seeking services at participating LGBTQ organizations.

Inclusion Criteria

Youth must be seeking services at the participating LGBTQ organizations

Youth must endorse current suicidal ideation on the BHS

Exclusion Criteria

Youth lack enough English-language proficiency to complete the BH-Works program

I understand what is required to participate in this study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 month

Initial screening and consent process

Adaptation and Training

Adaptation of BH-Works for LGBTQ organizations and training of staff in suicide risk management and affirmative care

18 months

Bi-monthly training consultations

Pilot Program Implementation

Pilot the adapted BH-Works program within LGBTQ organizations and collect initial feedback

1 month

Focus groups and feedback sessions

Program Evaluation

Run the program and collect data on feasibility, acceptability, and preliminary effectiveness

17 months

Ongoing data collection and evaluation

Follow-up

Participants are monitored for program satisfaction and effectiveness after implementation

2 months

Closing focus groups and interviews

Treatment Details

Interventions

• The BH-Works Suicide Prevention Program for Sexual and Gender Minority Youth

Trial Overview The BH-Works Suicide Prevention Program is being tested to see if it can help prevent suicide among SGM youth. It includes policy support, staff training, health screening, safety planning, referral systems, data analytics for monitoring programs and a collaborative structure for long-term use.

Participant Groups

Group I: SGM BH-Works Implementation Experimental Treatment 1 Intervention

For this phase of the study, the adapted version of the BH-works program (SGM BH-Works) will be implemented into LGBTQ+ Community Organizations. The BH-Works program offers screening, training, and referral coordination.

Who Is Running the Clinical Trial?

Virginia Polytechnic Institute and State University

Lead Sponsor

Trials

162

Recruited

26,900+

Drexel University

Collaborator

Trials

160

Recruited

48,600+

Thomas Jefferson University

Collaborator

Trials

475

Recruited

189,000+

Carilion Clinic

Collaborator

Trials

85

Recruited

15,400+

Diversity Camp, Inc.

Collaborator

Trials

1

Recruited

260+

Mazzoni Health Center

Collaborator

Trials

1

Recruited

260+

Findings from Research

Transgender and gender diverse (TGD) youth are at a higher risk for suicidal thoughts and behaviors compared to their cisgender peers, highlighting the urgent need for effective treatments.

A case study of a self-identified gender nonconforming adolescent showed that modifications to attachment-based family therapy (ABFT) led to significant reductions in suicidal symptoms and improved family communication over 24 weeks, suggesting that ABFT may be a promising intervention for TGD youth at risk for suicide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Demonstrating Attachment-Based Family Therapy for Transgender and Gender Diverse Youth with Suicidal Thoughts and Behavior: A Case Study. Russon, J., Smithee, L., Simpson, S., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Suicide Prevention Interventions for Sexual & Gender Minority Youth: An Unmet Need. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Sexual and Gender Minority Youth Suicide: Understanding Subgroup Differences to Inform Interventions. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Demonstrating Attachment-Based Family Therapy for Transgender and Gender Diverse Youth with Suicidal Thoughts and Behavior: A Case Study. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Systematic Review of Interventions to Reduce Suicide Risk in Transgender and Gender Diverse Youth. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Suicidality Among Psychiatrically Hospitalized Lesbian, Gay, Bisexual, Transgender, Queer, and/or Questioning Youth: Risk and Protective Factors. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Suicide attempts among sexual-minority youths: population and measurement issues. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Violence Victimization, Substance Use, and Suicide Risk Among Sexual Minority High School Students - United States, 2015-2017. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

Associations between LGBTQ+-supportive school and community resources and suicide attempts among adolescents in Massachusetts. [2023]