Feasibility Trial of a Single Session of Crisis Response Planning for Youth at High Risk for Suicide

Abstract

Suicide is the second leading cause of death among adolescents, yet access to mental health care remains limited. Youth have unique developmental and contextual considerations as they are avid users of digital technologies, which may influence how they engage with mental health interventions. Crisis Response Planning (CRP), a single-session intervention, has shown promise in adults but has not been systematically evaluated in youth. This study tested the feasibility, acceptability, and preliminary effectiveness of a chat-based version of CRP for adolescents with suicidal ideation (SI). Fifty-one adolescents (ages 14–18 years) endorsing recent SI were randomized to one of three single-session interventions: (1) chat-based CRP, (2) in-person CRP, or (3) virtual self-guided safety planning (control) (NCT06164106). Feasibility, usability, and other implementation outcomes were assessed post-treatment. Suicide risk was evaluated at baseline and two weeks post-treatment using the Ask Suicide Screening Questions (ASQ) and the Beck Scale for Suicidal Ideation (BSSI). All three treatments were rated as acceptable and feasible, though chat-based CRP was rated as more appropriate than the control. Approximately 40% of the sample no longer reported past-week SI at follow-up, with no group differences in binary SI outcomes. BSSI scores decreased in the chat-based CRP and control arms, but not in the in-person CRP arm. Results indicate that CRP and other safety planning interventions are feasible and acceptable for adolescents experiencing SI. Virtual formats, especially those that prioritize privacy and eliminate video, may be aligned with adolescent needs though continued development of scalable, youth-centered suicide prevention strategies is needed.