Promote Access to Stop Suicide: Comparison of Follow up Services for Youth at Risk for Suicide

The proposed project will be able to provide services to high-risk youth in Ohio. This
randomized controlled trial for youth discharged from inpatient psychiatric hospital will be
able to determine what combination of services is best suited to reduce subsequent suicide
attempts and re-hospitalization.

All youth (ages 10-18), that fit the inclusion criteria, will be recruited from the inpatient
unit at Fairview Youth Inpatient Unit. Patients will be consented, enrolled, and assigned to
group by the Research Coordinator working at the unit. The Methodologist/ Statistician will
generate a random allocation sequence using random number generator and communicate group
assignment to the Research Coordinator. There will not be any restriction on randomization.
The PI will be blinded to all group assignments.

The clinical research tools and screens that will be administered in this study include:
Columbia-Suicide Severity Rating Scale (C-SSRS), The Suicidal Ideation Questionnaire (SIQ),
The Adverse Childhood Experiences (ACEs), Ohio Scales, Children's Global Assessment Scale
(CGAS), Clinical Global Impressions (CGI-I).

The participants of the study will be seen by the child psychiatrist (Dr. Varkula) and the
research coordinator at the initial appointment, and a 6 month follow-up (Dr. Falcone). The
C-SSRS and the SIQ will be administered at the initial appointment and the follow-up
appointment. The study's research coordinator will be regulating the 3 month phone call and
scheduling the 6 month up visit and administering the Ohio Scales questionnaire with the
parents and/ or guardians of the child. There will also be a 12 month follow-up phone call
conducted by the research coordinator. During this time, the information for the C-SSRS
questionnaire, the SIQ, the Ohio Scales (for both the parent and the child), the CGI-I, and
the CGAS will be administered.

Inclusion Criteria:

- All patients (ages 10-18 years) admitted to the Cleveland Clinic Inpatient Child and
Adolescent psychiatry unit after a suicide ideation, behavior, or attempt.

- This can be defined by any intentional, nonfatal self-injury, regardless of medical
lethality, will be consider a suicide attempt if intent to die was indicated.

- Signed consent by the adult patient (18 years) or by a first-degree relative or a
guardian (for children) at the time of enrollment in the study, and assent by the
children as soon as is feasible.

Exclusion Criteria:

- Patients with a known history of autistic spectrum disorder, non-verbal patients and
moderate or severe mental retardation (IQ less than 70 and those patients in special
education full time), patients with substance dependency and patients with
schizophrenia.

- Patients who are enrolled in case management will also be excluded from the study.