Youth-Nominated Support Teams for Youth at Clinical High Risk for Psychosis (YST-CHR): A Novel Approach to Suicide Prevention in Early Psychosis

Aim

Individuals at clinical high risk for psychosis (CHR) constitute a very high-risk group for suicide and suicidal behaviour, yet they are typically excluded from trials of suicide prevention interventions. As such, there are no evidence-based suicide prevention approaches tailored to the unique needs of this population. This study aimed to adapt the Youth-Nominated Support Team (YST), a suicide prevention strategy with demonstrated efficacy, for use with CHR youth (YST-CHR).

Methods

YST-CHR was designed as an adjunctive intervention, offered alongside ongoing clinical care to mobilise informed support from trusted adults in a youths' life. Using a formative adaptation approach, we conducted focus group interviews with key informants and convened expert consensus meetings to guide the adaptation process.

Results and Discussion

Modifications were made to (1) pre-intervention preparatory activities, (2) availability of resources for clinicians, (3) the support person nomination and orientation process and (4) the format and schedule of contacts between support persons and clients. Additional recommendations that could not be incorporated into our preliminary test of YST-CHR, but may be considered in future studies, included an expanded role for peer providers and the incorporation of virtual reality to educate support persons about psychotic symptoms.

Conclusion

A small feasibility study currently underway will inform further development of YST-CHR. The modifications described here lay the groundwork for a scalable, key-informant-informed model of suicide prevention tailored to the unique needs of youth at CHR.