Integrated Suicide Supports and Safety Planning for Youth

The current study aims to evaluate the Jaspr app relative to usual care among youth (ages 13-21 years) who indicate suicidal ideation in pediatric medical settings. The Jaspr app includes supported safety planning between the young person and the healthcare provider, as well as skills and support videos for youth and caregivers intended to increase coping and decrease distress with an opportunity to access these resources through an at home app. Adolescents, parents, and clinicians will participate in the project to assess the effectiveness of Jaspr augmenting usual care, compared to usual care alone. The study will use a pre-post design in which each setting begins with a control period and then transitions to the addition of Jaspr following healthcare provider training on use of the app. Participants and their parents/caregivers will receive study assessments at baseline, 1-month, and 2-month follow up timepoints, and healthcare providers complete a survey at baseline, and the end of each period (control and intervention). Study assessments with youth will ask about coping, suicidal ideation and severity, anxiety and depression, service utilization, functional impairment, access to lethal means, and acceptability of the app. Study assessments for parents/caregivers will ask about their self-efficacy in managing their youth's suicidality, acceptability of the videos/app, and service utilization for the youth. Healthcare providers will complete surveys assessing their self-efficacy in managing youth suicidality and feasibility of use of the app. Youth, their legal guardian, and healthcare providers each assent/consent to participate in the research procedures.

Youth Inclusion Criteria:

• Age 13 -21 years, an Ask Suicide Questions (ASQ) screen score of 1-5 with active ideation (not solely a history of a prior attempt) but no current plan or intent, or patient-reported suicidal thoughts and behaviors during a clinical assessment in a medical setting who are judged by a clinician to be appropriate for conducting higher level assessment in that setting (including a BSSA and/or safety planning) in order to support care at home.
• Parents/guardians: One "parent" per AYA will also be invited to participate.
• HCPs: All HCPs in participating settings who may conduct assessments of SI and safety planning (physicians, nurse practitioners/physician's assistants, social workers, mental health counselors, psychologists) will be invited to participate.
• All subjects must have access to the internet and a computer or tablet device.

Youth Exclusion Criteria:

• Concurrently enrolled in an affiliated Suicide Care Research Center study, no phone access, or non-English speaking.