TY  - JOUR
AU  - Lawrence-Sidebottom, Darian
AU  - Huffman, Landry Goodgame
AU  - Beam, Aislinn Brenna
AU  - McAlister, Kelsey
AU  - Guerra, Rachael
AU  - Parikh, Amit
AU  - Roots, Monika
AU  - Huberty, Jennifer
PY  - 2024
DA  - 2024/8/16
TI  - Using a Digital Mental Health Intervention for Crisis Support and Mental Health Care Among Children and Adolescents With Self-Injurious Thoughts and Behaviors: Retrospective Study
JO  - JMIR Form Res
SP  - e54816
VL  - 8
KW  - suicide
KW  - self-harm
KW  - collaborative care
KW  - behavioral health
KW  - telehealth
KW  - telemedicine
KW  - eHealth
KW  - collaborative
KW  - collaboration
KW  - suicidal
KW  - self-injury
KW  - crisis
KW  - crises
KW  - mental health
KW  - self-injurious
KW  - anxiety
KW  - depression
KW  - pediatric
KW  - pediatrics
KW  - child
KW  - children
KW  - youth
KW  - adolescent
KW  - adolescents
KW  - teen
KW  - teens
KW  - teenager
KW  - teenagers
KW  - mobile phone
AB  - Background: Self-injurious thoughts and behaviors (SITBs) are increasing dramatically among children and adolescents. Crisis support is intended to provide immediate mental health care, risk mitigation, and intervention for those experiencing SITBs and acute mental health distress. Digital mental health interventions (DMHIs) have emerged as accessible and effective alternatives to in-person care; however, most do not provide crisis support or ongoing care for children and adolescents with SITBs. Objective: To inform the development of digital crisis support and mental health care for children and adolescents presenting with SITBs, this study aims to (1) characterize children and adolescents with SITBs who participate in a digital crisis response service, (2) compare anxiety and depressive symptoms of children and adolescents presenting with SITBs versus those without SITBs throughout care, and (3) suggest future steps for the implementation of digital crisis support and mental health care for children and adolescents presenting with SITBs. Methods: This retrospective study was conducted using data from children and adolescents (aged 1-17 y; N=2161) involved in a pediatric collaborative care DMHI. SITB prevalence was assessed during each live session. For children and adolescents who exhibited SITBs during live sessions, a rapid crisis support team provided evidence-based crisis support services. Assessments were completed approximately once a month to measure anxiety and depressive symptom severity. Demographics, mental health symptoms, and change in the mental health symptoms of children and adolescents presenting with SITBs (group with SITBs) were compared to those of children and adolescents with no SITBs (group without SITBs). Results: Compared to the group without SITBs (1977/2161, 91.49%), the group with SITBs (184/2161, 8.51%) was mostly made up of adolescents (107/184, 58.2%) and female children and adolescents (118/184, 64.1%). At baseline, compared to the group without SITBs, the group with SITBs had more severe anxiety and depressive symptoms. From before to after mental health care with the DMHI, the 2 groups did not differ in the rate of children and adolescents with anxiety symptom improvement (group with SITBs: 54/70, 77% vs group without SITBs: 367/440, 83.4%; χ21=1.2; P=.32) as well as depressive symptom improvement (group with SITBs: 58/72, 81% vs group without SITBs: 255/313, 81.5%; χ21=0; P=.99). The 2 groups also did not differ in the amount of change in symptom severity during care with the DMHI for anxiety (t80.20=1.37; P=.28) and depressive (t83.75=–0.08; P=.99) symptoms. Conclusions: This study demonstrates that participation in a collaborative care DMHI is associated with improved 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 children and adolescents presenting with SITBs, thereby addressing the public health issue of acute mental health crisis in children and adolescents. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2024/1/e54816
UR  - https://doi.org/10.2196/54816
DO  - 10.2196/54816
ID  - info:doi/10.2196/54816
ER  -