BACKGROUND Suicide is a leading cause of death among adolescents in North America. Youth who present to the Emergency Department (ED) with acute suicidality are at increased risk for eventual death by suicide, thereby presenting an opportunity for secondary prevention of suicide. The current study evaluates the effectiveness of a standardized individual and family-based suicidal behaviour risk reduction intervention targeting adolescents at high-risk for suicide. METHODS A randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of a manualized youth- and family- based suicide prevention strategy (SPS) as compared with case navigation (NAV) among adolescents aged 12 to 18 years of age who present to the ED with acute suicidal ideation (SI) or suicide risk behaviours (SRB). We will recruit 128 participants and compare psychiatric symptoms including SI/SRB, family communication, and functional impairment at baseline and follow-ups (post-intervention [6 weeks], 24 weeks). The primary outcome is change in suicidal ideation measured with the Suicide Ideation Questionnaire- Junior. SRBs are measured with the Suicide Behaviour Questionnaire. Secondary outcomes are change in depressive and anxious symptoms measured with semi-structured psychiatric interview and Screen for Child Anxiety Related Disorders; acute mental health crises measured by urgent medical (including ED) visits; family communication measured with Conflict Behaviour Questionnaire, functional impairment measured by Columbia Impairment Scale; cost effectiveness, and fidelity of implementation measured by audio recording and fidelity checklist. DISCUSSION Results of this study will inform a larger multi-centre RCT that will include both community and academic hospitals in urban and rural settings. Study results will be shared at international psychiatry and emergency medicine meetings, in local rounds, and via publication in academic journals and clinician-oriented newsletters. If effective, the intervention may provide a brief, scalable, and transportable treatment program that may be implemented in a variety of settings, including those in which access to children's mental health care services is challenging. TRIAL REGISTRATION ClinicalTrials.gov: NCT03488602, retrospectively registered April 4, 2018.

中文翻译：

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向急诊科就诊的有自杀相关行为的青少年的自杀预防策略：随机对照试验方案。

背景 自杀是北美青少年死亡的主要原因。因急性自杀而到急诊科 (ED) 就诊的青少年最终死于自杀的风险增加，从而为自杀的二级预防提供了机会。目前的研究评估了针对自杀高危青少年的标准化个人和基于家庭的自杀行为风险降低干预措施的有效性。方法 将进行一项随机对照试验 (RCT)，以评估手动的基于青年和家庭的自杀预防策略 (SPS) 与病例导航 (NAV) 相比，在 12 至 18 岁的青少年中的有效性。急诊室有急性自杀意念（SI）或自杀风险行为（SRB）。我们将招募 128 名参与者，并在基线和随访（干预后 [6 周]、24 周）时比较精神症状，包括 SI/SRB、家庭沟通和功能障碍。主要结果是使用自杀意念问卷-初级测量的自杀意念的变化。SRB 是用自杀行为问卷测量的。次要结果是通过半结构化精神病学访谈和儿童焦虑相关疾病筛查测量的抑郁和焦虑症状的变化；通过紧急医疗（包括急诊）就诊衡量的急性心理健康危机；家庭沟通用冲突行为问卷测量，功能障碍用哥伦比亚损伤量表测量；通过录音和保真度检查表衡量的成本效益和实施保真度。讨论 本研究的结果将为更大的多中心 RCT 提供信息，该 RCT 将包括城市和农村环境中的社区和学术医院。研究结果将在国际精神病学和急诊医学会议、地方巡回会议上以及通过在学术期刊和面向临床医生的通讯上发表来分享。如果有效，干预可以提供一个简短的、可扩展的和可移动的治疗计划，可以在各种环境中实施，包括那些难以获得儿童心理保健服务的环境。试验注册 ClinicalTrials.gov：NCT03488602，回顾性注册于 2018 年 4 月 4 日。研究结果将在国际精神病学和急诊医学会议、地方巡回会议上以及通过在学术期刊和面向临床医生的通讯上发表来分享。如果有效，干预可以提供一个简短的、可扩展的和可移动的治疗计划，可以在各种环境中实施，包括那些难以获得儿童心理保健服务的环境。试验注册 ClinicalTrials.gov：NCT03488602，回顾性注册于 2018 年 4 月 4 日。研究结果将在国际精神病学和急诊医学会议、地方巡回会议上以及通过在学术期刊和面向临床医生的通讯上发表来分享。如果有效，干预可以提供一个简短的、可扩展的和可移动的治疗计划，可以在各种环境中实施，包括那些难以获得儿童心理保健服务的环境。试验注册 ClinicalTrials.gov：NCT03488602，回顾性注册于 2018 年 4 月 4 日。包括那些难以获得儿童心理保健服务的机构。试验注册 ClinicalTrials.gov：NCT03488602，回顾性注册于 2018 年 4 月 4 日。包括那些难以获得儿童心理保健服务的机构。试验注册 ClinicalTrials.gov：NCT03488602，回顾性注册于 2018 年 4 月 4 日。