Development of an Emergency Department Family Navigator and Text Message Intervention for Caregivers to Reduce Youth Risk of Suicide and Self-injurious Behavior

Mary Kathryn Cancilliere; Kate M Guthrie; Kathleen Donise; Timmy Lin; Lindsay Orchowski; Anthony Spirito

Development of an Emergency Department Family Navigator and Text Message Intervention for Caregivers to Reduce Youth Risk of Suicide and Self-injurious Behavior

R I Med J (2013). 2024 Aug 1;107(8):28-38.

Authors

Mary Kathryn Cancilliere¹, Kate M Guthrie², Kathleen Donise³, Timmy Lin⁴, Lindsay Orchowski², Anthony Spirito⁵

Affiliations

¹ Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI; Department of Psychiatry and Human Behavior at The Warren Alpert Medical School, Brown University, Providence, RI.
² Department of Psychiatry and Human Behavior at The Warren Alpert Medical School, Brown University, Providence, RI; The Miriam Hospital, Providence, RI.
³ Department of Psychiatry and Human Behavior at The Warren Alpert Medical School, Brown University, Providence, RI; Emma Pendleton Bradley Hospital, East Providence, RI.
⁴ Rhode Island Hospital, Providence, RI.
⁵ Department of Psychiatry and Human Behavior at The Warren Alpert Medical School, Brown University, Providence, RI.

PMID: 39058987

Abstract

Background: Suicide and self-injurious behavior (SSIB) in youth 10 to 14 years old has rapidly increased, with suicide rates for youth 10 to 18 years being the second leading cause of death. Youth with SSIB seen in the Emergency Department (ED) are often discharged to the community, yet less than 40% receive subsequent mental health (MH) care within 30 days. This open pilot study examined the feasibility, acceptability, and sample characteristics of a two-component Family Navigator with text messaging intervention, ED REaCH, for caregivers of youth with SSIB discharged from the ED.

Methods: Sixteen dyads of youth (M=12.67; SD=1.09) seeking emergency care for SSIB and their caregivers were enrolled from the ED of a pediatric hospital in the northeast US from November 2023 to March 2024. Dyads were enrolled in the ED REaCH intervention consisting of navigation procedures to promote linkage to care, engagement in community-based MH care for youth with SSIB, and a digital platform to extend purported mechanisms underlying the intervention's efficacy (MH literacy, MH communication, and MH engagement). Data was collected on measures of social identities, demographics, functioning, MH services, and intervention satisfaction.

Results: All (100%) caregivers accepted the text messages. Most (75%) utilized the Family Navigator and completed the intervention feedback interviews. Overall, caregivers endorsed positive experiences and satisfaction with the two-component intervention. All caregivers who utilized the Family Navigator reported that 100% of youth attended MH care.

Conclusion: Preliminary findings suggest that the content and delivery methods of this intervention are perceived by caregivers as feasible and acceptable. As such, next steps include the evaluation of the ED REaCH intervention in a randomized clinical trial design. Future directions need to focus on intervention scalability, adaptability, personalization, and sustainability.

Keywords: Emergency Department; Family Navigator; Suicide; Text Messages; Youth.

MeSH terms

Adolescent
Caregivers* / psychology
Child
Emergency Service, Hospital*
Female
Humans
Male
Pilot Projects
Self-Injurious Behavior* / prevention & control
Suicide Prevention*
Text Messaging*