ASAP intervention may prevent postdischarge suicidal behaviour among adolescents
The As Safe as Possible (ASAP) intervention programme appears to help lessen the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality, suggests a recent study.
Although the ASAP intervention showed no statistically significant effect on suicide attempt, the findings were in the hypothesized direction for occurrence of an attempt (16 percent vs 31 percent; χ2, 1.86; df, 1; g, –0.36) and time to an attempt (hazard ratio [HR], 0.49; 95 percent CI, 0.16–1.47).
History of a suicide attempt significantly moderated treatment outcome, with a stronger, albeit nonsignificant, effect of the ASAP intervention among participants with a history of suicide attempt (HR, 0.23; 0.05–1.09). Treatment effects on suicidal ideation were not found.
Moreover, the smartphone app BRITE (median usage, 19 times) was used by 70 percent of the participants, who reported high satisfaction with both the intervention and the app.
“The ASAP intervention program shows promise in reducing the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality and merits further study,” the authors said.
For this study, 66 adolescents hospitalized for suicidal ideation (n=26) or a recent suicide attempt (n=40) across two sites were randomized to the ASAP intervention programme plus treatment as usual or to treatment as usual alone.
A 3-hour intervention delivered on the inpatient unit, ASAP focuses on emotion regulation and safety planning. Meanwhile, the BRITE app allowed participants to rate their level of emotional distress regularly and provided personalized strategies for emotion regulation and safety planning.
Suicide attempts following hospital discharge and suicidal ideation were assessed by a blind, independent evaluator at 4, 12 and 24 weeks postdischarge.