Implementing a “Digital Clinic” to Improve Suicide Risk Assessment and Management in Ambulatory Care

Grant Application

Tina Goldstein, PhD, UPMC Western Psychiatric Hospital

Proposed Innovation

Adolescent suicide is a pressing public health problem in America. It has increased dramatically over the past decade and is now the second leading cause of death among adolescents. The use of technology has shown promise in augmenting mental health care for suicidal youth.

The BRITE app is a smartphone-based safety planning and skills app for suicidal adolescents that was developed by University of Pittsburgh researchers. The app promotes self-monitoring and self-management in daily life by providing personalized coping strategies and skills. Input from teens during the BRITE development process helped to ensure the app design was appealing and user-friendly. The aim of this project is to implement a “digital clinic” in which BRITE is incorporated into standard mental health care for teens and young adults at risk of suicide.

Improvement in Action

In an initial research study, adolescents hospitalized for suicide risk used the BRITE app as part of a brief evidence-based therapy with a research study clinician. Results showed the 6-month suicide attempt rate was halved (versus community care without BRITE). In a subsequent larger study, BRITE was associated with lower risk for suicide attempts following discharge.

Through this project, a “digital clinic” will be created with the BRITE app integrated into standard mental health care to augment treatment. This will be done through UPMC Services for Teens at Risk (STAR) and College Option (COSTAR) clinics, which provide outpatient care to more than 400 suicidal youth each year. The goal is to improve suicide risk assessment and management of adolescents (ages 13-18) and young adults (ages 18-24). An easy-to-use BRITE clinician portal also will be developed for providers to inform them of progress, encourage collaboration, and increase clinician efficiency.

Intended Outcomes

Augmenting STAR/COSTAR treatment with BRITE promises to further improve patient outcomes and satisfaction by enhancing accessibility of therapy tools during high-risk periods. It is expected to result in more personalized treatment, improved patient-provider communication, and an increased belief by at-risk patients that they can keep themselves safe from self-harm.