The Development and Feasibility Outcomes of a Youth Suicide Prevention Intensive Outpatient Program

Suicide is a leading cause of death in adolescents worldwide. There is an absence of effective and low cost treatment strategies for this growing public health problem. Current practice consists of brief hospitalization of acutely suicidal youth, but many get inadequate follow-up treatment. There are few alternatives to individual outpatient services offered at too low an intensity for an acutely distressed population. This paper describes the development, feasibility, acceptability, and preliminary clinical outcomes of an intensive outpatient program (IOP) for suicidal adolescents over a two-year period.

364 eligible adolescents (12-18 years) who had a worsening of suicidal ideation or a suicide attempt were enrolled in an IOP and attended at least 1 group session. Depressive symptoms and suicidality were assessed at baseline and discharge from the program and at one and six month follow-up.

The majority of patients completed the IOP (81.0%; average of nine sessions). Over 95% of teens and parents responded that they were mostly or very satisfied with the IOP. The condition of patients improved at the time of discharge on depressive symptoms and suicidal ideation and behavior. 286 of the 364 youth (78.6%) completed the six-month follow-up. In total, 8.7% and 27.3% of the 286 respondents reported a suicide attempt and event, respectively, within six months of discharge from the IOP.

While limited by the lack of a control group, our findings suggest that an IOP for adolescents with suicidality is acceptable and feasible as either a step-down from or an alternative to inpatient treatment.