Implementation of Suicide Prevention in Outpatient Pediatric Behavioral Health: Leveraging clinician, youth, and family perspectives

About This Grant

PROJECT SUMMARY/ABSTRACT Suicidal thoughts and behaviors are increasingly prevalent among youth in the United States. Pediatric outpatient mental healthcare settings are critical sites for suicide prevention. Despite changes in clinical practice guidelines and accreditation standards recognizing pediatric mental health providers’ responsibility to implement evidence-based practices (EBPs) for suicide prevention, little is understood about how to optimize such practices for the outpatient context. Further, minimal research has captured the perspectives of youth patients who have received suicide prevention EBPs during treatment or those of their caregivers, who are often at the forefront of suicide prevention efforts. The specific aims of the proposed study are to: (1) Understand the lived experiences of key constituents and identify contextual determinants of implementation of a evidence-based suicide prevention pathway within outpatient pediatric mental healthcare, and (2) Develop a set of contextually tailored implementation strategies to optimize and sustain suicide prevention implementation in pediatric mental healthcare using a community-engaged approach. The current study proposes to recruit a sample of pediatric mental health clinicians, youth patients (ages 12-18), and patient caregivers from public, outpatient child psychiatry clinics to participate in qualitive interviews. Additionally, the current study proposes to form a group of implementation leaders (pediatric clinicians and clinic directors) to participate in the Implementation Mapping process. Researchers and leaders will partner to operationalize implementation strategies that are: responsive to the needs of youth patients and families and enhance EBP fit with the outpatient care context. Research aims support the applicant’s training goals to: (1) Enhance knowledge of dissemination and implementation science with a focus on qualitative research and Implementation Mapping, (2) Develop specialized expertise in suicide prevention research and practice in health systems, and (3) Gain foundational training in community-engaged research methods with a specific focus on partnering with community members to develop strategies to increase access to evidence-based mental health services. The applicant’s mentorship team is comprised of experts in youth mental health services and community-engaged research methods (Dr. Meinzer), implementation science and qualitative methods (Dr. Rudd), and suicide prevention research (Dr. Weinstock). The mentoring team will advance the applicant’s goals to pursue research training at the intersection of suicide prevention and implementation science and to utilize participatory methods. The proposed research and training plan ultimately supports the candidate’s long-term goal of pursuing a career as an NIH-funded, independent researcher dedicated to understanding strategies for enhancing suicide prevention within youth-serving systems. The proposed study centers the lived experiences of frontline clinicians, youth, and families in the development of implementation strategies that can be harnessed in future clinical research trials of suicide prevention interventions.