As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents
Open accessAbstract
OBJECTIVE: The authors report on a pilot study of an inpatient intervention for suicidal adolescents, As Safe as Possible (ASAP), supported by a smartphone app (BRITE) to reduce suicide attempts following hospital discharge. METHOD: Across two sites, 66 adolescents hospitalized for suicidal ideation (N=26) or a recent suicide attempt (N=40) were randomly assigned to the ASAP intervention program plus treatment as usual or to treatment as usual alone. ASAP, which focuses on emotion regulation and safety planning, is a 3-hour intervention delivered on the inpatient unit. The BRITE app prompted participants to rate their level of emotional distress on a daily basis and provided personalized strategies for emotion regulation and safety planning. A blind, independent evaluator assessed suicide attempts following hospital discharge and suicidal ideation at 4, 12, and 24 weeks after discharge. RESULTS: =1.86, df=1, g=-0.36) and time to an attempt (hazard ratio=0.49, 95% CI=0.16, 1.47). Past history of a suicide attempt was a significant moderator of treatment outcome, with a stronger, albeit nonsignificant, effect of the ASAP intervention among participants with a history of suicide attempt (hazard ratio=0.23, 95% CI=0.05, 1.09). There were no treatment effects on suicidal ideation. The majority of participants (70%) used the BRITE app (median usage, 19 times). Participants reported high satisfaction with both the intervention and the app. CONCLUSIONS: The ASAP intervention program shows promise in reducing the incidence of postdischarge suicide attempts among adolescents hospitalized for suicidality and merits further study.
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In teens, two brief interventions - TOC and ASAP - yielded encouraging, yet non-significant results.
“Similarly, in teens, two brief interventions -Teens Options for Change (TOC) 290 and As Safe As Possible (ASAP) 291 -yielded encouraging, yet non-significant results.”
From Suicide and suicide risk (2019) · cites this paper as [290]
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- Authors
- Kennard, B. D., Goldstein, T., Foxwell, A. A., McMakin, D. L., Wolfe, K., Biernesser, C., Moorehead, A., Douaihy, A., Zullo, L., Wentroble, E., Owen, V., Zelazny, J., Iyengar, S., Porta, G., & Brent, D.
- Affiliations
- Florida International University (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2018-09-01
- Volume
- 175
- Issue
- 9
- Pages
- 864-872
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC6169524
- OpenAlex
- W2883970607
- Cited by
- 154
- References
- 11
- Citations by year
- 2026: 12 · 2025: 24 · 2024: 25 · 2023: 17 · 2022: 23 · 2021: 19 · 2020: 26 · 2019: 5 · 2018: 2
- FWCI
- 15.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Foundation for Suicide Prevention
- Healthwise
- University of Oxford
- Substance Abuse and Mental Health Services Administration
- Health Resources and Services Administration
- National Institute of Mental Health (R34MH100375)
- National Institute on Drug Abuse
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- adolescent suicide prevention, suicide attempts, hospitalized adolescents, mobile application, emotion regulation, safety planning, suicide attempt history, suicidal ideation, app usage
- MeSH terms
- Suicide Prevention, Adolescent, Child, Female, Humans, Inpatients, Male, Stress, Psychological, Suicide, Suicide, Attempted, Suicidal Ideation, Mobile Applications
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