BACKGROUND
Self-injurious thoughts and behaviors (SITBs) and underlying mental health problems are increasing dramatically among children and adolescents. Pediatric DMHIs have emerged as accessible and effective alternatives to in-person care; however, most do not provide crisis support or ongoing care for youth with SITBs.
OBJECTIVE
To inform development of digital crisis support and mental health care for SITB-presenting youth, the current study aims to 1) characterize youth with SITBs who participate in a digital crisis response service, 2) compare anxiety and depressive symptoms of SITB-presenting youth to non-SITB-presenting youth throughout care, and 3) suggest future steps for implementation of digital crisis support and mental health care to SITB-presenting youth.
METHODS
This study was conducted using retrospective data from members (children and adolescents) involved in a pediatric collaborative care DMHI. SITBs were assessed during each session with a practitioner. For members who exhibited SITBs during behavioral health coaching and other non-clinical sessions, a rapid crisis support team provided evidence-based crisis support services. Monthly DSM-5 assessments measured anxiety and depressive symptom severity.
RESULTS
The SITB group (n = 93) tended to be older and more predominantly female than the non-SITB group (n = 929). Compared to the non-SITB group at baseline, the SITB group had more severe anxiety and depressive symptoms. Symptom severity improved over months of participation (anxiety: F1,287 = 64.85, P < .001; depression: F1,145 = 28.63, P < .001), and the rate of improvement did not differ between the SITB and non-SITB groups.
CONCLUSIONS
The current study demonstrates that participation with a collaborative care DMHI is associated with improvements in mental health outcomes in children and adolescents experiencing SITBs. These results provide preliminary insights for the use of pediatric DMHIs in crisis support and mental health care for SITB-presenting youth.