Practice Facilitation for Youth Suicide Prevention

Overseen By Vivian Thompson, MPH

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Colorado, Denver

Disqualifiers: Over 24 years, No positive ASQ

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 aims to improve how primary care providers detect and manage suicide risk in young people. It will test whether adding extra support and coaching, known as practice facilitation, helps clinics use a suicide prevention plan more effectively compared to just training providers. The goal is to determine if this extra support reduces suicide attempts, suicidal thoughts, and emergency visits, while increasing the likelihood that at-risk youth see a mental health professional. Young individuals aged 12 to 24 who visit a participating clinic and receive a positive result on a suicide risk screening during a check-up may qualify for the trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative strategies that could enhance mental health care for young people.

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 practice facilitation method is safe for youth suicide prevention?

Research has shown that using practice facilitation to support suicide prevention in primary care is generally safe. This method helps clinics regularly implement tools like screening and safety planning. Although specific data on risks or side effects for the facilitation itself is lacking, similar programs have demonstrated positive outcomes, such as better use of safety plans and improved coping skills in teenagers.

The absence of negative events in these programs suggests they are well-tolerated. Practice facilitation primarily involves training and support, making it unlikely to cause harm. Since this is not a drug or medical device, safety concerns are minimal. Participants can feel confident that the focus remains on improving care and prevention without significant risk. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Practice Facilitation for youth suicide prevention because it offers a unique approach to integrating mental health pathways into everyday primary care. Unlike standard training programs that simply educate healthcare providers, Practice Facilitation provides ongoing support to help practices implement these pathways more effectively and make them a regular part of care. This method could lead to more consistent use of suicide prevention strategies, potentially improving outcomes for at-risk youth. By embedding these practices into routine care, there's hope for a more proactive and sustained approach to reducing youth suicide rates.

What evidence suggests that Practice Facilitation is effective for youth suicide prevention?

This trial will compare two approaches: Practice Facilitation and Training Only. Studies have shown that practice facilitation helps primary care providers better identify and manage suicide risk in young people. Research indicates that when providers receive support to include suicide prevention strategies, they feel more confident and informed. This support enables them to effectively use tools like suicide risk screening and safety planning. Early findings suggest these methods can reduce suicide attempts and suicidal thoughts in young people. This approach also encourages more follow-ups with mental health professionals, reducing emergency room visits. Overall, practice facilitation enhances the use of suicide prevention methods, potentially lowering the risk of youth suicide. ^{1 2 6 7 8}

Who Is on the Research Team?

Bruno J Anthony, PhD

Principal Investigator

University of Colorado School of Medicine - Anschutz Medical Campus

Are You a Good Fit for This Trial?

This trial is for primary care providers (PCPs) who manage youth at risk of suicide. It aims to integrate a suicide prevention pathway into routine care, enhancing PCP's ability to detect and address suicidality in young patients.

Inclusion Criteria

I am a young person attending a check-up at a participating doctor's office.

Youth receive a positive ASQ screen during their well visit

All staff in enrolled Primary Care practices (e.g., physicians, physician assistants nurses, administrative staff) will be eligible to participate and complete relevant measures.

Exclusion Criteria

Youth do not receive a positive ASQ screen at well visit.

I am older than 24 years.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Primary care practices are trained in the NIMH youth suicide prevention pathway

6 months

Monthly individual check-ins

Practice Facilitation

Practice facilitation is added to training to provide implementation support for integrating the pathway into routine care

6 months

Monthly individual check-ins

Follow-up

Participants are monitored for safety and effectiveness after training and facilitation

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Practice Facilitation

Trial Overview The study tests if adding Practice Facilitation (PF)—which includes support like coaching—to Training Only (TO) in the NIMH Youth Suicide Prevention Pathway improves its adoption by clinics and helps reduce youth suicidality more effectively than training alone.

How Is the Trial Designed?

Group I: Practice Facilitation Experimental Treatment 2 Interventions

Practice facilitation is added to training in the suicide prevention pathway in primary care to provide implementation support for integrating the pathway into routine care

Group II: Training Only Active Control 1 Intervention

Primary care practices are trained in the National Institute of Mental Health (NIMH) youth suicide prevention pathway without practice facilitation

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials

1,842

Recruited

3,028,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

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]

A 1-hour virtual training significantly improved clinicians' knowledge and self-efficacy in using electronic safety plans for suicide prevention, with lasting effects observed at a 6-month follow-up.

Among clinicians working with suicidal youth, 81% attempted to use the electronic safety plan template, and 63% completed it, indicating that this training can enhance the implementation of safety planning in community settings despite some challenges like technology issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a Virtual Suicide Safety Planning Training on Clinician Knowledge, Self-Efficacy, and Use of Safety Plans in Community Mental Health Clinics. Whitmyre, ED., Esposito-Smythers, C., Goldberg, DG., et al.[2023]

The comprehensive body system review (BSR) in the Safety Monitoring Uniform Report Form (SMURF) identified 129 additional adverse events (AEs) in pediatric patients, significantly more than the 48 AEs from the general inquiry and 16 from the drug-specific inquiry, highlighting its effectiveness in capturing important safety data.

Parents found the detailed BSR acceptable and satisfactory, while clinicians did not share the same level of acceptance, indicating a potential gap in the perceived utility of detailed adverse event reporting methods in pediatric psychopharmacology.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of increasingly detailed elicitation methods for the assessment of adverse events in pediatric psychopharmacology. Greenhill, LL., Vitiello, B., Fisher, P., et al.[2007]

The pilot Patient Safety Presentation process, implemented in a psychiatry residency program, significantly improved residents' knowledge and engagement in patient safety practices, as evidenced by pre- and post-presentation surveys involving 32 residents.

All participating residents expressed satisfaction with the presentation, highlighting its effectiveness as a model for enhancing patient safety education in residency programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Pilot of a Process for Regularly Sharing Summary Patient Safety Data. Kim, B., Grech, SM., Rembisz, AE., et al.[2023]

The study successfully implemented the Safety Planning Intervention (SPI) for adolescent suicidality in emergency services, showing that training significantly improved providers' attitudes and knowledge about the intervention.

Collaboration with stakeholders and brief training were effective strategies for integrating structured safety planning into pediatric emergency settings, which is crucial for enhancing care for suicidal youths.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety Planning Intervention for Adolescents: Provider Attitudes and Response to Training in the Emergency Services Setting. Bettis, AH., Donise, KR., MacPherson, HA., et al.[2022]

The study successfully translated and validated the 'Global Trigger Tool-Psychiatry' (GTT-P) for identifying iatrogenic adverse events in psychiatric care in Norway, incorporating insights from both health professionals and service users to enhance its effectiveness.

Implementing the GTT-P can help mental health nurses in Norway and Sweden to better identify potential triggers for adverse events, ultimately improving patient safety and reducing the risk of harm in psychiatric settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a research tool to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals. Okkenhaug, A., Tritter, JQ., Landstad, BJ.[2023]

The concept of suicide intervention offers a more neutral approach compared to traditional suicide prevention, allowing for the possibility of supporting individuals who may see death as a valid option due to chronic distress.

This model challenges existing suicide prevention methods by addressing complex feelings about life and death, suggesting that for some individuals, a focus on the quality of life and the appropriateness of death may be necessary in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide: issues of prevention, intervention, and facilitation. Nelson, FL.[2022]

Citations

1. ctv.veeva.com ctv.veeva.com/study/practice-facilitation-to-enhance-implementation-of-a-pediatric-suicide-prevention-pathway

Practice Facilitation to Enhance Implementation of a Pediatric ... Use of available tools have shown the potential to boost primary care providers' (PCPs) detection of suicide risk and confidence and knowledge ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06619782

Practice Facilitation to Enhance Implementation of a ... The proposed study will assess the impact of the investigators Facilitated Suicide Prevention program--which provides support to assist practices in integrating ...

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

Suicide Prevention in Youth - PMC This review presents new research pertinent to youth suicide prevention with a focus on suicide risk screening; therapeutic interventions, ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1876285925000154

Suicide Prevention Training in Pediatric Primary Care With our scoping review, we found limited research on the effectiveness of suicide prevention training of pediatric primary care providers. Suicide prevention ...

5. withpower.com withpower.com/trial/phase-suicide-9-2024-df62f

Practice Facilitation for Youth Suicide Prevention This trial is for primary care providers (PCPs) who manage youth at risk of suicide. It aims to integrate a suicide prevention pathway into routine care, ...

6. link.springer.com link.springer.com/article/10.1007/s11920-025-01620-w

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

7. sciencedirect.com sciencedirect.com/science/article/pii/S2949732924000966

Developing and Piloting Suicide Prevention Training in ... This article describes a first step in community-participatory development and pilot evaluation of a suicide prevention training series for PPCCs.

8. srcd.onlinelibrary.wiley.com srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.30

Preventing adolescent suicide: Recommendations for ... A key suicide prevention strategy is reducing access to the means (i.e., methods) by which someone can take their life. Reducing access to a “ ...