Youth Nominated Support Team Intervention-Emergency Department
Funded by Mcubed, University of MichiganPrincipal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Alex Rogers, M.D., Joseph Himle, Ph.D., Alejandra Arango, Ph.D., Cynthia Ewell Foster, Ph.D., Victor Hong, M.D.
This project will adapt the Youth-Nominated Support Team (YST) intervention for use in an ED setting and pilot test this adapted intervention with 20 adolescents. We recently reported that the addition of the YST to usual care for suicidal adolescents was associated with decreased long-term mortality. Those in the YST group nominated ‘caring adults’ (family, school, community) who were given tailored information about risk factors, adolescent diagnosis, and treatment plans; and were encouraged to maintain weekly contact with the youths to facilitate treatment adherence and positive behavioral choices. Professional staff provided support to these adults via weekly telephone contacts across a 3-month period. Long-term follow-up demonstrated a 6.6 –fold higher risk of death in the youths who did not receive the YST, with a confidence interval suggesting a 50% reduction in mortality for the YST group. As a next step, it is important to determine if the YST is efficacious when launched in different settings, including the ED, where large numbers of suicidal youth present for services and many are discharged home. We will also examine feasibility and acceptability with participation in YST and recommendations for improvement.
Targeted Firearm Safety Education to Reduce Morbidity and Mortality in Rural Youth
Funded by the National Institute of Mental Health (R24HD087149)
Principal Investigators: Cheryl A. King, Ph.D. & Cynthia Ewell Foster, Ph.D.
Our long-term goal is to develop an effective, universal strategy to increase safe firearm storage in rural communities. In this two-phase pilot project, we will use a community-based participatory research (CBPR) model in Phase One to develop a culturally tailored firearm safety message and to identify the community-based messengers and messaging strategies that are most acceptable and perceived as having the greatest likelihood of being impactful with rural families. In Phase Two, we will pilot test the acceptability and feasibility of our new prevention strategy: a multicomponent online intervention that includes a culturally tailored website, video, infographic fact sheet, and parent-child firearm safety contract/home safety checklist. We will focus on families with children at two different developmental periods: 1) mobile infants and toddlers and 2) older children/teens (ages 8-18). This delivery strategy capitalizes on what are hypothesized to be “critical periods” of behavior change in families in the hopes of creating safe storage behaviors that could impact not only unintentional injuries among young children but also firearm-related deaths in teens that may be due to suicide or other intentional injuries.
24-Hour Warning Signs for Adolescent Suicide Attempts
Funded by the National Institute of Mental Health (R01MH113582)
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Iqbal Ahamed, Ph.D., Courtney Bagge, Ph.D., David Brent, M.D., Charlie Casper, Ph.D., Polly Gipson, Ph.D., Jacqueline Grupp-Phelan, M.D, MPH
This large-scale NIMH project recruited 1097 youth at elevated risk for suicide from the ED-STARS study. The project is designed to identify the warning signs that are associated with near-term risk for suicide. We also hope to determine why a patient attempted suicide on a given day versus a day without a suicide attempt. Youth will complete biweekly text message surveys across an 18-month period, regarding their mental health status. The Warning Signs for Suicide Attempt Interview – Adolescent (WSSA-A), a computer-assisted telephone interview, will be conducted with adolescents who report a suicide attempt (and matched control adolescents). Using a case-crossover within-subject design, we will compare the events, behaviors, emotions and thoughts of these adolescents during the 24-hour case window (day of attempt) to those during a matched 24-hour control window. Using a case-control group comparison design, we also will identify differences between suicide attempters and non-attempters in events, behaviors, emotions and cognitions during the 24-hour case window.
Developing an Adaptive Intervention for Suicidal Adolescents Following Inpatient Hospitalization: A Pilot SMART
Funded by the National Institute of Mental Health (K23MH113776)
Principal Investigator: Ewa Czyz, Ph.D.
This NIMH K award will be used to conduct a Sequential, Multiple Assignment, Randomized Trial (SMART) pilot with teens at risk for suicide (ages 13-17). Given the heterogeneity of responses to intervention and post-discharge suicide risk among suicidal youth, this personalized approach represents a critical first step in developing an innovative, technology-augmented adaptive intervention for hospitalized adolescents aimed at reducing suicide-related outcomes following the transition from inpatient care. Findings from this study will provide the groundwork for the construction of a technology-augmented adaptive intervention that could lead to a reduction in suicidal behaviors and related events during the high-risk post-discharge period—an important suicide prevention target.
Electronic Bridge to Mental Health for College Students (eBRIDGE)
Funded by the National Institute of Mental Health (R01MH103244)
Principal Investigator: Cheryl A. King, Ph.D.
Co-Investigators: Daniel Eisenberg, Ph.D., Todd K. Favorite, Ph.D., Inbal Nahum-Shani, Ph.D., Kai Zheng, Ph.D.
Site Principal Investigators: Ronald Albucher, M.D., William Coryell, M.D., Jacqueline Pistorello, Ph.D.
This research initiative began with an intervention development grant funded by the National Institute of Mental Health (NIMH), which enabled us to develop, pilot-test and iteratively refine a theoretically-driven intervention, Students’ eBridge to Mental Health (eBridge). This online intervention screens students for mental health concerns that include elevated suicide risk and facilitates their linkage to mental health (MH) services. eBridge is designed to work on computers, tablets and smartphones (i0S, Android) and is easily adaptable to evolving technologies in the future. It incorporates motivational interviewing (MI) principles and draws from health behavior models that emphasize autonomy and self-determination. Following a web-based screen using standardized scales to identify students at elevated risk, eBridge offers students options for personalized feedback (provided online in a conversational MI-adherent format) and corresponding online with professionals trained in MI and knowledgeable about university and community resources. We are currently conducting a larger more definitive efficacy trial at four universities: the University of Michigan, the University of Nevada-Reno, the University of Iowa, and Stanford University.
Emergency Department Screen for Teens at Risk for Suicide (ED-STARS)
Funded by the National Institute of Mental Health (U01MH104311)
Principal Investigators: Cheryl A. King, Ph.D., Jacqueline Grupp-Phelan, M.D., M.P.H., David Brent, M.D.
University of Michigan Co-Investigators: Alex Rogers, M.D., Rebecca Cunningham, M.D., Kyle Grazier, Ph.D.
Dr. King together with Dr. David Brent (University of Pittsburgh) and Dr. Jackie Grupp-Phelan (Cincinnati Children’s Hospital) are leading this large-scale NIMH collaborative project (U Award) aimed at improving the identification of youth at risk for suicide. This project is designed to develop and validate a computerized adaptive screen (CAS) for adolescent suicide risk. This screen will be brief, tailored and adaptive – with individualized sequences of screening questions conditional on previous responses. A wide range of acute suicide risk indicators will be tested for possible inclusion in the CAS. This project will test how the computerized adaptive screen performs as a screen relative to the Ask Suicide-Screening Questions (ASQ). We will also examine the incremental value of the Implicit Association Test (IAT), a behavioral test of implicit suicidal cognitions, which is important as many at-risk youth may deny suicidal thoughts. ED-STARS is a collaborative project with the Pediatric Emergency Care Applied Research Network (PECARN) in addition to the Whiteriver PHS Indian Hospital.
Family Support and Follow-Up Program-Psychiatric Emergency Services
Funded by Substance Abuse and Mental Health Services Administration and Michigan Department of Health and Human Services
Principal Investigator: Cynthia Ewell Foster, Ph.D.
Based on work completed in Michigan’s cohort 5 GLS project and in partnership with the University of Michigan Health System’s Psychiatric Emergency Services (PES), the Family Support and ED Follow-up Program aims to inform enhancements to crisis and emergency care for youth and families. 250-500 families will be enrolled at PES. Youth ages 10-18 with any suicide-related risk factors are eligible. Youth and parents complete surveys in PES and participate in follow-up surveys online (parents at 3 days and 2 weeks after discharge; youth at 2 weeks after discharge). Surveys are designed to help improve our understanding of how to care for youth seeking emergency services for suicide risk. Eventually, some families will be asked to join a focus group to inform the development of a text-message-based follow-up intervention for parents/caregivers of high risk youth. Funded by the state-wide youth suicide prevention grant, we hope to disseminate best practices to other emergency departments across Michigan.
Promoting Resilience and Outreach through Multi-tiered Interventions and Supportive Environments (PROMISE)
Funded by the Robert Wood Johnson Foundation
Principal Investigator: Polly Gipson, PhD
The goal of PROMISE is to implement a multi-disciplinary, multi-pronged approach to identifying and addressing trauma in adolescents. Research informs us that the devastating impacts of traumatic exposure not only threaten the healthy physical and mental development of its victims, but also threaten their ability to perform adequately in school. Because youth spend the majority of their time within school and require optimal functioning to succeed academically, trauma informed schools are an important first step in providing opportunities for adolescent victims and witnesses of trauma to thrive. PROMISE will be implemented in an urban, Southeastern Michigan community, specifically a school with high adverse childhood experiences, poverty, and community violence. PROMISE consists of a multi-tiered approach: 1) create safe environments and promote health; 2) early intervention and identification of individuals at-risk for post/secondary traumatic stress; and 3) intensive support and services for those exhibiting clinically significant traumatic stress symptoms.
Transforming Youth Suicide Prevention in Michigan
Funded by Substance Abuse and Mental Health Services Administration to State of Michigan
Co-Principal Investigators: Patricia Smith & Cynthia Ewell Foster, Ph.D.
The TYSP-MI 2 Project is a 3.75 million dollar five year grant awarded to the State of Michigan’s Department of Community Health to support a state-wide public health approach to youth suicide prevention. Focused on sustainable systems change, this grant establishes collaborative relationships between state agencies focused on injury prevention and control, child protective services, behavioral health, and education. The grant provides gatekeeper and clinical provider training and community-based technical assistance, funds state-wide data surveillance initiatives, and supports the development of urban and rural “model communities” working to establish a continuum of best-practice services in their counties.
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Arango, A., Clark, M., & King, C. A. Predicting the severity of peer victimization and bullying perpetration among youth with interpersonal problems: A 6-month prospective study. Journal of Adolescence. 2022.
Bornheimer, L. A., Cobia, D., Li Verdugo, J., Holzworth, J., & Smith, M.J. (2022). Clinical insight and cognitive functioning as mediators in the relationships between symptoms of psychosis, depression, and suicide ideation in first episode psychosis. Journal of Psychiatric Research, 147, 85-93.
Bornheimer, L. A., Czyz, E., Jung Koo, H., Li Verdugo, J., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R. C., Coryell, W., Favorite, T., & King, C. (2022). Suicide risk profiles and barriers to professional help-seeking among college students with elevated risk for suicide. Journal of Psychiatric Research, 152, 305-312.
Bornheimer, L. A., Hong, V., Li, J., Fernandez, L., & King, C. (2022). Relationships between hallucinations, delusions, depression, suicide ideation and plan among adults presenting with psychosis in psychiatric emergency care. Psychosis, 14(2), 109-119.
Bornheimer, L. A., Li Verdugo, J., Holzworth, Im, V., Smith, F., Sliwa, H., Taylor, S. F., King, C. A., Florence, T., Tarrier, N., & Himle, J. A. (2022). Modifying a cognitive behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health. Psychiatry Research, 311, 114505.
Bornheimer, L. A., Li Verdugo, J., Holzworth, J., Smith, F. N., & Himle, J. A. (2022). Mental health provider perspectives of the COVID-19 pandemic impact on service delivery: A focus on challenges in remote engagement, suicide risk assessment, and treatment of psychosis. BMC Health Services Research, 22, 718.
Bornheimer, L. A., Martz, M. E., Suzuki, T., Tso, I. F., Burton, C. Z., Li Verdugo, J., Grove, T., Heitzeg, M. M., & Taylor, S. F. (2022). Affective dysregulation precedes emergence of psychosis-like experiences in a community sample of young adults. Schizophrenia Bulletin. [Epub ahead of print].
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Coryell W, Eisenberg D, Zheng K, Horwitz A, Albucher R, Pistorello J, Favorite T, King CA. Suicidality and alcohol use as predictors of future suicidal behavior in college students. Alcohol and Alcoholism. 2022; DOI: 10.1093/alcalc/agac037
Czyz, E. K., Koo, H. J., Al-Dajani, N., Kentopp, S. D., Jiang, A., & King, C. A. (2022). Temporal profiles of suicidal thoughts in daily life: Results from two mobile-based monitoring studies with high-risk adolescents. Journal of Psychiatric Research.
Czyz, E. K., Koo, H. J., Al-Dajani, N., King, C. A., & Nahum-Shani, I. (2022). Predicting short-term suicidal thoughts in adolescents using machine learning: Developing decision tools to identify daily-level risk after hospitalization. Psychological Medicine. In press.
Harness, Jane “What does "Stranger Things" have to do with mental health?” University of Michigan Health Blog, July 6, 2022
Harness, Jane “Why Caregivers Should Worry About Elon Musk Buying Twitter” AACAP News, July 2022
Harness J, Fitzgerald K, Sullivan H, Selkie E. Youth Insight About Social Media Effects on Well/Ill-Being and Self-Modulating Efforts. Journal of Adolescent Health. Published online June 2022:S1054139X22004190. doi:10.1016/j.jadohealth.2022.04.011
Harness, Jane “Papageno Effect in Media: Fails and Triumphs” JAACAP Connect 2022
Hill RM, Oosterhoff B, King CA, & Kaplow JB. Open trial of a brief, web-assisted behavior intervention to reduce thwarted belongingness and suicidal ideation among adolescents: The Supporting Grieving Teens intervention. Counseling and Psychotherapy Research. 2022; DOI: https://doi.org/10.1002/capr.12582
Horwitz, A. G., Czyz, E. K., Al-Dajani, N., Dempsey, W., Zhao, Z., Nahum-Shani, I., & Sen, S. (2022). Utilizing daily mood diaries and wearable sensor data to predict depression and suicidal ideation among medical interns. Journal of Affective Disorders.
Horwitz, A. G., Hong, V., Eisenberg, D., Zheng, K., Albucher, R., Coryell, W., Pistorello, J., Favorite, T., & King, C. A. (2022). Engagement With Personalized Feedback for Emotional Distress Among College Students at Elevated Suicide Risk. Behavior therapy, 53(2), 365–375.
King CA, Eisenberg D, Pistorello J, Coryell W, Albucher RC, Favorite T, Horwitz A, Bonar EE, Epstein D, Zheng K: Electronic bridge to mental health for college students: A randomized controlled intervention trial. J Consult Clin Psychol: 2022. PM35099205
Kuehn, K. S., Foster, K. T., Czyz, E., King, C. A. (2022) Identifying person-specific coping responses to suicidal urges: A case series analysis and illustration of the idiographic method. Suicide and Life-Threatening Behavior. In press.
Meeks LM, Cleary J, Horwitz A, Pereira-Lima K, Zhao Z, Fang Y, Sen S: Analysis of Depressive Symptoms and Perceived Impairment Among Physicians Across Intern Year. JAMA Netw Open 5(1): e2144919, 2022. PM35076705
Rana, G. S., Nordsletten, A., Sivananthan, M., & Hong, V. (2022). A 6-year retrospective review of psychiatric emergency service utilization by school-age children. Clinical Child Psychology and Psychiatry. https://doi.org/10.1177/13591045211070924
Shobassy, A., Nordsletten, A. E., Ali, A., Bozada, K. A., Malas, N. M., & Hong, V. (2022). Effects of the COVID-19 pandemic in a psychiatric emergency service: Utilization patterns and patient perceptions. The American journal of emergency medicine, 52, 241–243.
Wexler, L., Apala Flaherty, A., Begum, F., White, L., Kouassi, L., Wisnieski, D., Davis, A., & Ewell Foster, C. (2022). Describing meanings and practices related to firearms, safety, and household storage in rural Alaska Native communities. Journal of Rural Mental Health. Advance online publication. https://doi.org/10.1037/rmh0000207
Arango, A., Gipson, P.Y., Votta, J., & King, C.A. Saving lives: Recognizing and intervening with youth at risk for suicide (2021). Annual Review of Clinical Psychology, 17. 2021. PMID: 33544628
Bornheimer, L. A., Acri, M., Li Verdugo, J., & McKay, M. (2021). Family processes and mental health among children and caregivers in a family strengthening program. Journal of Child and Family Studies, 30(11), 2903-2912. 8.
Bornheimer, L. A., Li, J, & Thompson, S. (2021). Depression mediates the relationships between hallucinations, delusions, and social isolation in first-episode psychosis. Social Work Research.
Bornheimer, L. A., Tarrier, N., Brinen, A. P., Dwyer, M., Li, J., & Himle, J. (2021). Longitudinal predictors of stigma in first-episode psychosis (FEP): Mediating effects of depression. Early Intervention in Psychiatry, 15(2), 263- 270.
Bornheimer, L. A., Wojtalik, J., Li, J, Cobia, D., & Smith, M. J. (2021). Suicidal ideation in first-episode psychosis: Considerations for depression, positive symptoms, clinical insight, and cognition. Schizophrenia Research, 228, 298- 304.
Coryell W, Horwitz A, Albucher R, Zheng K, Pistorello J, Eisenberg D, Favorite T, King C: Alcohol intake in relation to suicidal ideation and behavior among university students. J Am Coll Health: 1-5, 2021. PM34398708
Czyz, E. K., Glenn, C. R., Arango, A., Koo, H. J., & King, C. A. Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents. Journal of affective disorders. 2021.
Czyz, E. K., Koo, H. J., Al-Dajani, N., King, C. A., & Nahum-Shani, I. (2021). Predicting short-term suicidal thoughts in adolescents using machine learning: Developing decision tools to identify daily-level risk after hospitalization. Psychological Medicine, 1-10.
Ewell Foster, C., Magness, C., Czyz, E., Kahsay, E., Martindale, J., Hong, V., Baker, E., Cavataio, I., Colombini, G., Kettley, J., Smith, P. K., & King, C. (2021). Predictors of Parent Behavioral Engagement in Youth Suicide Discharge Recommendations: Implications for Family-Centered Crisis Interventions. Child psychiatry and human development, 10.1007/s10578-021-01176-9. Advance online publication. https://doi.org/10.1007/s10578-021-01176-9
Flaherty, H. B. Bornheimer, L. A., Hamovitch, E., Garay, E., Mini, M., Acri, M., & McKay, M. (2021). Examining Organizational Factors Supporting the Adoption and Use of Evidence-Based Interventions. Community Mental Health Journal, 57, 1187-1194.
Harness J, Weigle P, “Mental Health Advocacy and Contagion: A Double-Edged Sword?” AACAP News, December 2021
Harness J, Pierce J, Malas N. Psychiatric Evaluation and Management in Pediatric Spinal Cord Injuries: a Review. Curr Psychiatry Rep. 2021;23(7):40. doi:10.1007/s11920-021-01256-6
Harness, Jane, and Arash Javankbakht. “Trauma.” Trauma | Anxiety and Depression Association of America, ADAA, ADAA, 4 June 2021, adaa.org/understanding-anxiety/trauma.
Harness, Jane “Dramatization of media portrayal of suicide over time: A comparison of The Virgin Suicides to 13 Reasons Why” JAACAP Connect 2021
King, C. A., Gipson, P. Y., Arango, A., Lernihan, D., Clark, M., Ewell Foster, C., ... & Stone, D. LET’s CONNECT Community Mentorship Program for Adolescents with Peer Social Problems: A Randomized Intervention Trial. American Journal of Community Psychology. 2021.
Li, J., Bornheimer, L.A., Fernandez, L., & Dagher, J. (2021). The relationships between risk-taking, depression and alcohol use in the experience of suicidal ideation among adults in the general population. Crisis: The Journal of Crisis Intervention and Suicide Prevention. [Epub ahead of print].
Micol, V., Prouty, D., & Czyz, E. K. (2021). Enhancing motivation and self-efficacy for safety plan use: incorporating motivational interviewing strategies in a brief safety planning intervention for adolescents at risk for suicide. Psychotherapy. In press.
Schatten, H. T., Brick, L. A., Holman, C. S., & Czyz, E. (2021). Differential time varying associations among affective states and suicidal ideation among adolescents following hospital discharge. Psychiatry Research, 305, 114174.
Presenter, “Concepts and Considerations in EMA Research for Suicide Prevention.” Presentation with B. Stanley, R. Auerbach, H. Galfalvy, & M. Nock. Webinar hosted by the American Foundation for Suicide Prevention (virtual). June 30, 2022.
Wexler, L., White, L., ^Moto, R., (2022, June) Translating Prevention Research into Community Practice: Implementing and Measuring Community-Engaged Learning and Action. Panel Presentation. Society for Prevention Research 2022 Annual Meeting. Seattle, WA.
White, L. A., Kirk, T., Garnie, J., Schmidt, T., McEachern, D., Wexler, L. (2022, May) Collaborative and Culturally Responsible Suicide Prevention Programming. National Academy of Science Engineering and Medicine’s Forum on Mental Health and Substance Use Disorders, Suicide Prevention in Indigenous Communities: A Workshop.
White, L.A. Markowski, K., Schmidt, T., McEachern, D., Wexler, L., (2022, March) Social Support as an Avenue for Strengths-Based Alaska Native Suicide Prevention: An Examination of Youth Support Profiles in Alaska Native Villages. Brownbag Presentation. Social Psychology Area, University of Michigan.
White, L. A., Wexler, L., McEachern, D., Schmidt, T. (2022, March) Collaborative and Cultural Responsible Suicide Prevention Programming: Promoting Community Conversations about Research to End Suicide (PC CARES). University of Michigan School of Social Work, ENGAGE Community Showcase.
Bornheimer, L. A., Czyz, E., Jung Koo, H., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R. C., Coryell, W., Favorite, T., & King, C. A. (2022, June). Profiles of suicide risk and professional help-seeking barriers among college students with elevated risk for suicide. Oral presentation at the inaugural Suicide Research Symposium.
Bornheimer, L. A., Li Verdugo, J., Holzworth, J., Taylor, S. F., King, C. A., Florence, T., & Himle, J. A. (2022, June). Adapting a suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health. Oral presentation at the inaugural Suicide Research Symposium.
Bornheimer, L. A., Li Verdugo, J., Taylor, S. F., King, C. A., & Himle, J. A. (2022, May). Modifying a cognitive behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health. Poster presentation at the annual University of Michigan Department of Psychiatry Albert J. Silverman Conference.
Bornheimer, L. A., Li Verdugo, J., Holzworth, J., Smith, F., Himle, J. A., Taylor, S. F., King, C. A., & Tarrier, N. (2022, April). Adapting a cognitive behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders. Poster (virtual) presentation at the annual 2022 Congress of the Schizophrenia International Research Society (SIRS).
Bornheimer, L. A., Li Verdugo, J., Holzworth, J., Smith, F., Im, V., Sliwa, H., & Himle, J. A. (2022, January). Client, Peer, and Provider Stakeholder Input on the Modification of a Cognitive Behavioral Suicide Prevention Treatment for Adults with Psychosis. Poster presentation at the annual Society for Social Work and Research conference, Washington, DC.
Bornheimer, L. A., Li Verdugo, J., Holzworth, J. (2022, January). Impact of COVID-19 on Provider Assessment and Treatment of Psychosis and Suicide Risk. Poster presentation at the annual Society for Social Work and Research conference, Washington, DC.
Bornheimer, L. A., Humm, L., Kallen, M. A., Coles, M. E., Mastroleo, N., Vas, S., & Smith, M, J. (2022, January). Validity and Acceptability of a CBT Skills Assessment Tool for Simulated Training in The Treatment of Anxiety Disorders. Poster presentation at the annual Society for Social Work and Research conference, Washington, DC.
Suicide Research Symposium: “In-app features of social media platforms to help youth modulate use”, virtual, June 16 2022
Grand Rounds Presentation at University of Michigan: “Censorship of Social and Entertainment Media for Youth Part II” virtual, January 19, 2022