Nudging Parental Actions for Youth Suicide Prevention

This study tests a text messaging program that helps parents keep their teens safe after a visit to the emergency department for suicidal thoughts or behavior. Adolescents face a higher risk of suicide after leaving the emergency department, and limiting access to lethal means such as firearms, medications, or other dangerous items can help prevent suicide. The investigators invite parents and their teens aged 12 to 17 who visit the emergency department at Children's Medical Center Dallas for suicide-related reasons to join the study. After enrolling, families will be randomly assigned to one of three groups. The first group receives usual care, which includes standard counseling about keeping teens safe in the emergency room and no study text messages. The second group receives direct text messages three times a week with reminders about safety reminders. The third group receives risk-framing text messages three times a week, which include safety reminders and information about suicide risk following an emergency room visit to motivate parents to take action. The study measures whether these text messages help parents follow safety recommendations at home. Parents and teens complete short surveys at the start of the study, six weeks later, and twelve weeks later. The study also tracks whether the teen returns to the emergency department or attempts suicide again. The study aims to determine if text messages can increase parental safety practices, reduce teens' access to lethal means, and prevent future suicide attempts. UT Southwestern Medical Center and Children's Health Dallas conduct the study. Messages are delivered through a secure, HIPAA-compliant virtual platform to ensure privacy.

Inclusion criteria

• Guardian must be able and willing to provide informed consent, and the participant must be able and willing to provide assent.
• Parent and adolescent willingness and ability to participate in study procedures and complete assessments at baseline, 6 weeks, and 12 weeks.
• Presentation to the ED for a suicide-related emergency, defined as suicidal ideation within the last 2 weeks or a suicide attempt within the past month.
• Adolescents aged 12-17 years during the consent.
• Access to a mobile phone with text messaging capability for the parent/legal guardian.
• Ability to communicate in English.

Exclusion criteria

• Absence of a legal guardian capable of providing consent.
• Parents/legal guardians without access to a mobile phone with texting capability.
• Inability to communicate in English.
• Adolescents in state custody or under legal restrictions that prevent study participation.
• Adolescents involved in the justice system in a manner that would interfere with study participation.
• Adolescents with autism spectrum disorder or intellectual development disorder needing substantial or very substantial support