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Leveraging Technology to
Prevent Adolescent Suicide
Kimberly H. McManama O’Brien, PhD
Boston Children’s Hospital/Harvard Medical School/Simmons College
Health Experience Refactored Conference 2016
Designing to Support Mental Health
April 5, 2016
MORTALITY FROM MEDICAL CAUSES
10 Leading Causes of Death by Age Group, United States – 2014
Data Source:
National Vital Statistics System, National
Center for Health Statistics, CDC.
Produced by:
National Center for Injury Prevention and
Control, CDC using WISQARSTM.
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
U.S Suicide Rate by Age 2001-2010
Youth Risk Behavior Survey, 2011
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
Suicide is about communication
The inability to speak our pain
The inability of others to hear our pain
Dese’Rae L Stage
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School
The development and testing of Crisis Care was supported by grants and
awards from:
• Program for Patient Safety and Quality at Boston Children’s Hospital
• Simmons College Fund for Research
• Simmons School of Social Work
• Hacking Pediatrics Mashup
• Mad*Pow

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HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons College/ Boston Children's Hospital/Harvard Medical School

  • 1. Leveraging Technology to Prevent Adolescent Suicide Kimberly H. McManama O’Brien, PhD Boston Children’s Hospital/Harvard Medical School/Simmons College Health Experience Refactored Conference 2016 Designing to Support Mental Health April 5, 2016
  • 3. 10 Leading Causes of Death by Age Group, United States – 2014 Data Source: National Vital Statistics System, National Center for Health Statistics, CDC. Produced by: National Center for Injury Prevention and Control, CDC using WISQARSTM.
  • 5. U.S Suicide Rate by Age 2001-2010
  • 6. Youth Risk Behavior Survey, 2011
  • 15. Suicide is about communication The inability to speak our pain The inability of others to hear our pain Dese’Rae L Stage
  • 23. The development and testing of Crisis Care was supported by grants and awards from: • Program for Patient Safety and Quality at Boston Children’s Hospital • Simmons College Fund for Research • Simmons School of Social Work • Hacking Pediatrics Mashup • Mad*Pow

Notas del editor

  1. Hi everyone – it’s so great to have the opportunity to speak with you today about how we can leverage technology to ameliorate one of America’s biggest public health problems facing our youth – suicide. Suicide is a public health problem towards which we have not made much advancement – which is not true for other public health problems.
  2. This graph illustrates this in quite a disheartening way – stroke, AIDS, heart disease, leukemia – all public health problems that we as a society have made some strides towards – but then you look at that top line and you see suicide has not budged. Youth and young adults in particular, are disproportionately affected by suicide relative to other age groups.
  3. When you look at this this chart, check out the green boxes, which represent suicide. Suicide is 2nd leading cause of death for youth ages 10-24 years, accounting for more than one in ten deaths in this age group.
  4. There’s this spike in suicide rates and numbers during this developmental period, indicating that this is a key time to intervene.
  5. Look at this jump from almost none at grade 6, to almost 9 suicides per 100,000 in grade 12. It’s not just suicide deaths which pose a public health problem for our youth, but suicide-related thoughts and behaviors in general.
  6. Look at this jump from almost none at grade 6, to almost 9 suicides per 100,000 in grade 12. It’s not just suicide deaths which pose a public health problem for our youth, but suicide-related thoughts and behaviors in general.
  7. -In our hospital, every year, almost 700 suicidal teens enter our emergency department with their parents seeking help for their suicidal thoughts or in the aftermath of an attempt -After they are seen here, many of these teens return home with their parents, often still lacking the skills they need to cope
  8. -This is a problem, as the most critical period of suicide risk among adolescents is upon discharge from an acute care setting, such as an Emergency Department (ED) or inpatient psychiatric unit, after a suicidal event. -Also problematic is that despite high rates of suicide attempts and death by suicide after discharge from acute care facilities such as EDs and psychiatric units, few intervention efforts have been designed specifically for this high-risk population. -This risk likely exists because there is often a significant lag time between their hospital discharge and their next outpatient appointment – these teens need some kind of bridge between the acute care they receive in the hospital and the long term tx they will receive days or sometimes weeks after they are home. -So as clinical researchers we thought – what can we do? How can we improve continuity of care for suicidal teens? How can we reach them in this crucial time of need?
  9. …their phones… Teens are ALWAYS on their phones. In fact, a recent study by the Pew Research Center found that 25% of teens report they are on their phones “almost constantly.”
  10. Over 80% of teens ages 14-17 report owning a cell phone, with close to half owning a smartphone, with only slight variation across gender, race, and income.
  11. -Although the rapid growth in smartphone use is not always seen as positive, it is important that the mental health field recognizes this increase of use by adolescents as new opportunities for their implementation into mental health care. -In specific, smartphone apps have the potential to extend and supplement traditional psychosocial therapies.
  12. -Many smartphone apps have been developed recently for individuals to reduce stress, anxiety, and depression - They have also been used to self-monitor symptoms, including mood and suicidal ideation. -But I have yet to see an app specifically target suicidal teens and the family unit, which is unfortunate because smartphone apps represent a unique opportunity to reduce youth suicide risk by increasing communication and connection between teens, parents, and the help they need.
  13. -In fact, it is the presence of effective communication that may be the key to preventing suicide among adolescents. -When a suicidal teen is in distress, it is critical that they are able to communicate this to a trusting adult, hopefully their parent. And when the suicidal teen does come to their parent, the parent needs to know what to communicate back to their teens, and who else to communicate with to get the appropriate help.
  14. -Similar to communication, another family factor that protects against adolescent suicide is connection. Increasingly, research has demonstrated that low parental connectedness has been associated with psychological and social distress among adolescents while the parent-child connection is a protective factor for adolescent suicide. -Youth with a strong connection to their parents are less likely to report suicidal thoughts and family support is in itself protective against suicide.
  15. -A friend of mine, suicide attempt survivor Dese’Rae Stage, said at a conference recently….. -So, knowing that communication and connection are so critical to suicide prevention among youth, and that suicide may be a direct result of this breakdown in communication, we at BCH are leveraging technology to connect teens and their parents in the context of a suicidal crisis. We have developed a smartphone app for suicidal teens and their parents, that specifically targets the active ingredients of communication and connection.
  16. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  17. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  18. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  19. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  20. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  21. -Our app, called Crisis Care, is unique from other mental health apps in that it has two separate, but complementary, modes for the teen and the parent. -When the teen uses Crisis Care, they are able to access a set of personalized skills that they select, which ideally have been identified by the teen as helpful in the past in reducing suicidal thoughts.
  22. -Results from our pilot of our web based prototype of Crisis Care with 20 teens and their 20 parents demonstrate that the app is indeed usable by both parents and teens, and that parents and teens believe they would use it in the context of a suicidal crisis. -Crisis Care is one example of how to leverage technology to design for mental health in a way that will enhance human connection and communication, by the dual modes allowing it to target the parent/teen relationship, providing a different type of connection than what a simple text can do.
  23. -Crisis Care works by increasing the suicidal teen’s ability to communicate and connect with parents, treaters, and resources. This serves to increase parent involvement and coping skill use, which in turn, serves to decrease the teen’s suicidal thoughts and behaviors. -By establishing a custom-made connection to a support system, smartphone apps, such as Crisis Care, have the opportunity to provide a more comprehensive continuity of mental health care, in the time of greatest need, for those who need it most. THANK YOU