Brief Alcohol Intervention and mHealth Booster for Suicidal Adolescents

The primary goal of this study is to test the acceptability and feasibility of iASIST
(integrated Alcohol and Suicide Intervention for Suicidal Teens), a novel adjunctive
intervention for alcohol use and alcohol-related suicidal thoughts and behaviors for suicidal
adolescent inpatients.

The intervention in this study, iASIST (integrated Alcohol and Suicide Intervention for
Suicidal Teens), involves three components: 1) an individual intervention with the adolescent
in which motivational enhancement techniques are used to explore alcohol use as a risk factor
for continued suicide-related thoughts and behaviors in order to build the adolescent's
motivation to reduce or stop their alcohol use and to create a complementary change plan, 2)
a subsequent family intervention in which the interventionist facilitates a discussion
between the adolescent and parent about the change plan using motivational enhancement
techniques to align the parent with the adolescent to strengthen the adolescent's
self-efficacy and commitment to the change plan as well as the parent's ability to support
the adolescent in their plan to reduce or stop drinking, and 3) a post-discharge mHealth
booster to adolescents focused on strengthening their commitment to the change plan, and to
parents focused on their commitment, confidence, and ability related to supporting the
adolescent in reducing or stopping drinking. The investigators will first conduct an open
trial with 10 adolescents and their parents to test iASIST and make subsequent changes to the
booster. Next, the investigators will conduct a randomized trial with 50 adolescents and
their parents to test the feasibility and acceptability of iASIST as well as associations
with alcohol- and suicide-related outcomes at 3 months post-discharge, relative to
participants who receive an attention-matched comparison condition focused on the role of a
healthy lifestyle in mental health that includes a post-discharge mHealth control targeting
the maintenance of a healthy lifestyle.

The investigators anticipate that adolescents who receive iASIST, relative to the comparison
condition, will have increased negative alcohol expectancies, alcohol situational confidence,
mental health and/or substance abuse service use, parental monitoring, parent-child
communication about alcohol, and decreased frequency of alcohol use, positive alcohol
expectancies, suicide ideation, plans, and attempts at 3 month follow-up. Although the
investigators do not expect statistically significant differences due to the small sample
size, they will calculate confidence intervals around the effect sizes. Data will be
informative for designing a fully powered clinical trial.

Inclusion Criteria:

- Must be currently hospitalized for suicide ideation or attempt

- Must have used alcohol in past 3 months, indicated by selecting "yes" on the screening
question ["Have you drank alcohol in the past 3 months?"]

- Must be between the age of 13-17

- The adolescent and parent/guardian must own a smartphone

- Must have the ability to communicate in English.

Exclusion Criteria:

- developmental delay

- autism spectrum disorder

- psychosis