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Nationwide Children’s Hospital’s Innovative Approach to Suicide Prevention
As the nation grapples with a growing youth mental health crisis, new strategies are emerging to bridge gaps in care for those at risk of suicide. A recent study published in JMIR Pediatrics and Parenting highlights the effectiveness of text-based support systems in aiding youth as they transition from inpatient care or emergency departments.
The study, conducted by the Center for Suicide Prevention and Research (CSPR) at Nationwide Children’s Hospital, focuses on the implementation of “Caring Contacts,” an initiative designed to offer ongoing support to patients after their discharge. This approach utilizes text messages, postcards, and letters to provide non-demanding, supportive communication, a key aspect of the hospital’s Zero Suicide quality improvement framework.
Zero Suicide Framework and Its Impact
The Zero Suicide framework integrates best practices in suicide care, emphasizing routine screening for suicide risk, followed by comprehensive assessments and safety plans. This framework aims to reduce suicides within healthcare systems and ensure that patients receive consistent and effective support.
John Ackerman, Ph.D., child clinical psychologist and suicide prevention clinical manager at CSPR, notes the urgency of this initiative. “Prior research has shown that patients are around 300 times more at risk of suicide in the first week after hospital discharge, and 200 times more at risk over the first month compared to the general population,” he explains. “Reaching patients in their daily lives with messages of hope and validation is crucial.”
Details of the Caring Contacts Study
The study’s implementation involved sending supportive text messages and images designed to foster hope and connection. These messages, which also included crisis resources, were automatically sent to patients starting the day after their discharge. The initiative ran for four months, with message content development beginning in 2018 and data collection concluding in 2021.
Of the 1,700 patients who participated in the Caring Contacts program, 83% reported feeling moderately to very hopeful, while 88% felt moderately to very supported. A notable 92% of respondents believed their peers would benefit from similar messages, and 86% expressed interest in continuing to receive them in the future.
The study revealed varying enrollment rates among different age groups, with the highest rates among 18-year-olds and females enrolling at a higher rate (54%) than males (48%). The lowest enrollment was observed in 13-year-olds.
Future Directions and Implications
While the study presents promising results, researchers acknowledge the need for further work to measure clinical effectiveness and improve enrollment rates. Glenn Thomas, Ph.D., lead author and director of Behavioral Health Services at Nationwide Children’s, emphasizes the importance of continued support. “Patients need to know that we are here for them even after they leave our walls.”
The Caring Contacts initiative represents a significant step forward in suicide prevention, demonstrating how technology can be harnessed to offer continuous support and enhance care transitions. As mental health challenges among youth continue to evolve, such innovative approaches will be crucial in saving lives and providing essential support.
For more information, refer to the study: Glenn Vickers Thomas et al, Caring Contacts: Development and Implementation of Post-Discharge Text Messages to Adolescents with Suicidal Thoughts and Behaviors (Preprint), JMIR Pediatrics and Parenting (2024). DOI: 10.2196/51570.
