WeCare: A System of Care for Black Youth

Not Applicable

Recruiting

• Conditions: Suicidal Ideation
• Interventions: Behavioral: WeCare

• Registration Number: NCT05654207
• Lead Sponsor: New York University

Brief Summary

The overall goal of this study is to respond to the urgent need for an effective suicide prevention strategy for Black youth by examining the effectiveness of a systems-level strategy to recognize and respond to suicide risk among Black adolescents who present to emergency departments (EDs). The proposed strategy, WeCare, combines combines three components: (1) universal screening using the Computerized Adaptive Screen for Suicidal Youth (CASSY), (2) a brief intervention designed for Black youth with elevated suicide risk in for ED settings, Connections for Safety (CFS), that combines safety planning and strategies to support linkage to outpatient mental health services, and (3) supportive text messages to youth and parent/caregivers for six weeks following the youth's ED visit. Study objectives are (1) to integrate input from multiple stakeholders to inform and facilitate WeCare implementation, and (2) to use a hybrid one effectiveness-implementation design to evaluate its effectiveness.

Detailed Description

From 1991 through 2017, suicide attempts increased by 73% among Black high school-aged youth, and suicide attempts requiring hospitalization increased by 122% for Black high school-aged boys. These alarming findings, in part, led to the creation of the Emergency Taskforce on Black Youth Suicide and Mental Health and their subsequent report, Ring the Alarm: The Crisis of Black Youth Suicide in America, and passage of the Pursuing Equity in Mental Act. These all highlight the urgent need to improve suicide risk detection, treatment, and prevention among Black youth.

We propose to respond to these challenges and the urgent need for an effective suicide prevention strategy for Black youth by examining the effectiveness of an "easily implementable," "systems-level" strategy to recognize and respond to suicide risk among Black youth who present to EDs. WeCare combines (1) CASSY, a universal screening; (2) CFS, an intervention with elements from SAFETY-Acute (SAFETY-A), an evidence-based, family-centered intervention to safety planning for children and adolescents; (3) Safety Planning Intervention (SPI), a brief ED-based intervention of a written list prioritizing coping strategies and sources of support to alleviate a suicidal crisis; (3) Making Connections Intervention (MCI), a mental health engagement intervention for Black adolescents and their parents; and (4) a follow-up text messaging support system for youth and parents will be introduced for enhanced feasibility.

This study is a randomized clinical effectiveness trial with 2,200 Black youth at risk for suicide to examine the effectiveness of WeCare. Youth, ages 12 to 19 years, enrolled from two hospital EDs in New York City, will be assessed on enrollment for risks associated with suicide. Moderate/high-risk youth will be randomly assigned to WeCare vs. usual services. Survey assessments will be conducted at 3- and 6-month follow-up, with medical record review through 12 months to examine the effectiveness of WeCare and mediators of WeCare effects. The objective is to increase risk identification, treatment referral and engagement, and, in turn, reduce suicidal ideation and behavior among Black youth.

Study Timeline

• Study First Submitted: 2022-11-30
• Study First Submitted QC: 2022-12-08
• Study First Posted: 2022-12-16
• Study Start: 2024-04-08
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-09
• Last Update Posted: 2025-04-13
• Primary Completion: 2027-03-31
• Study Completion: 2027-03-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 2200

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
WeCare	WeCare	WeCare system of care - universal screening, ED-based intervention, text message follow-up.

Primary Outcome Measures

Name	Time	Method
Columbia-Suicide Severity Rating Scale	Baseline, Months 3 and 6	This measure is a semi structured interview to assess suicidal ideation and attempt This measure is a semi structured interview to assess suicidal ideation and attempt behavior (actual, interrupted, aborted suicide attempts; preparatory behavior).
Mental Health Outpatient Visits (Electronic Medical Record)	Baseline, Months 3 and 6	This measure assesses mental health service utilization from 50 patient care locations in New York City via electronic medical records.

Secondary Outcome Measures

Name	Time	Method
Caregiver Knowledge of Mental Health Services (Therapy Survey)	Baseline, Months 3 and 6	This measures expectations about treatment at a children's psychiatric clinic (caregiver).
Peer Victimization and Perpetration	Baseline, Months 3 and 6	This measure assesses bullying.
Barriers	Baseline, Months 3 and 6	This 5-item measure captures barriers to MH treatment participation identified in PI Lindsey's prior work with Black youth and families. A higher score indicates a perception of more barriers to treatment (Minimum score: 5; Maximum score: 15).
ED STARS Mental Health Service Use	Baseline, Months 3 and 6	This measure assesses mental health service utilization, efforts to link to services, linkage, and engagement with outpatient MH services (caregiver).
Attitudes Toward Psychological Help Scale	Baseline, Months 3 and 6	This measure assesses psychological factors, including stigma, perceived relevance of treatment, etc. that impact one's perceptions and attitudes about using formal mental health treatment services.
Hopelessness	Baseline, Months 3 and 6	This measure targets recent feelings of hopelessness and hope.
Parent-Family Connectedness Scale	Baseline, Months 3 and 6	This measure assesses familial connectedness.
Stages of Change	Baseline, Months 3 and 6	This 8-item measure assesses adolescents' willingness to change (Minimum score: 8; Maximum score: 32).
Barriers to Treatment Participation Scale	Baseline, Months 3 and 6	This measure assesses barriers to treatment (caregiver).
How I Feel about Friends	Baseline, Months 3 and 6	This 2-ite, measure assesses peer connectedness. Higher scores indicate greater peer connectedness (Minimum score: 2; Maximum score: 10).
Urgency Premeditated Perseverance Sensation Seeking Subscale	Baseline, Months 3 and 6	This measure assesses impulsivity.
Mental Health Service Use	Baseline, Months 3 and 6	This measure assesses lifetime mental health service use (caregiver).

Trial Locations

Locations (1)

Kings County Hospital; 🇺🇸 New York, New York, United States