Motivational interview intervention feasible, acceptable for young people at risk of suicide

March 22, 2021

2 min read

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A safety planning measure that included motivational interviews seemed feasible and acceptable for adolescents at risk of suicide, according to a presentation at the annual conference of the Anxiety and Depression Association of America.

“Adolescent suicide has increased significantly in recent years, as has the increase in certain psychiatric hospitalizations and emergency room visits for suicide risk problems.” Ewa Czyz, PhD, Research Associate Professor in the Department of Psychiatry at the University of Michigan said during a presentation. “[This research] is aimed at psychiatric and hospitalized adolescents, who are a particularly high-risk group. We know that many of these teenagers are at high risk of experiencing a suicidal event such as attempting suicide or being hospitalized in the weeks following their discharge. ”

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Few randomized controlled trials have focused on this high-risk transition period, which Czyz says underscores the “critical need” to develop approaches that target suicide risk in the post-discharge period. In the current randomized controlled pilot study, Czyz and colleagues attempted to evaluate a safety planning measure for at-risk adolescents that included motivational interviews and post-discharge contacts. They randomly assigned 36 adolescents, ages 13-17, of whom 79% were girls and 86% were white, to either usual treatment or the condition of the motivational interview safety plan, which included a one-hour one-on-one interview and meeting 30 -minute family meeting. Intervention group members and their parents received booster phone calls 2 weeks after discharge to further adjust the safety plan and better meet the needs of participants after discharge. In addition, all study participants completed daily surveys sent to their phones via SMS for 4 weeks, assessing the mechanisms of change, response to the intervention, and risk indicators.

The results showed a consent rate of 77% and a retention rate in the high 80s throughout the study period. Although approximately 24% of adolescents reported having suicidal thoughts during the study period, less than 1% of these responses met the study risk threshold when a counselor calls the adolescents and their families. The researchers therefore concluded that risk monitoring was doable, but required robust resources as someone had to be on call every day of the study. The satisfaction of the adolescents and parents both after the personal meetings and after the refresher interviews was high. The parents tended to rate the helpfulness of the intervention as higher than the adolescents. Adolescents in the state of the motivational interview safety plan reported higher self-efficacy when they refrain from suicidal measures, resort to and rely on themselves more often, and use the safety plan more often.

“Motivational interview strategies seem to show promise in terms of maintaining the use of security plans, although both groups saw a decline in the use of security plans over time,” said Czyz. “Additional context may be needed to maintain the use and management of the safety plan after discharge.”

Reference:

Czyz E et al. Building Resilience to Prevent Suicide: New Interventions. Presented at: the annual conference of the Anxiety and Depression Association of America; 18.-19. March 2021 (virtual meeting).

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Annual meeting of the Anxiety and Depression Association of America